Is polytetrafluoroethylene circular banding an effective technique for treatment of high-flow vascular access-induced steal syndrome?

2020 ◽  
Vol 39 (2) ◽  
pp. 387
Author(s):  
MedhatE El-Laboudy ◽  
WaleedA Sorour ◽  
AhmedM Tawfik
Keyword(s):  
Vascular Access ◽  
High Flow ◽  
Effective Technique ◽  
Steal Syndrome

The value of ultrasound in the multivariate assessment complications of permanent vascular access for hemodialysis

2021 ◽  
Vol 8 (1) ◽  
pp. 60-67
Author(s):  
T. V. Zakhmatova ◽  
V. S. Koen ◽  
R. E. Shtentsel
Keyword(s):  
Vascular Access ◽  
Ultrasound Examination ◽  
Main Tool ◽  
Duplex Ultrasound ◽  
Maximum Duration ◽  
Significant Difference ◽  
Dynamic Ultrasound ◽  
Access Complications ◽  
Design And Methods ◽  
Steal Syndrome

Background. The maximum duration of vascular access for hemodialysis functioning rarely exceeds 4 years. The main tool for diagnosing access dysfunction is duplex ultrasound. Dynamic ultrasound examination of vascular access is not included in the standard examination of patient undergoing hemodialysis in Russia.Objective. To study the structure of complications and changes in hemodynamics in the vascular access for hemodialysis and to determine the risk factors contributing to its development.Design and methods. Ultrasound, clinical and laboratory examination was performed in 550 patients undergoing program hemodialysis, 517 (94.0 %) of them had arteriovenous fistula, 33 (6.0 %) patients had arteriovenous graft.Results. Vascular access complications occurred in 26.7 % (147 patients), there was no significant difference in the detection rate of thrombosis (26.5 %), stenosis (23.8 %), and aneurysm (21.1 %). A combination of two complications was observed in 20.4 %, the steal syndrome — in 8.2 %. A correlation was established between the presence of significant stenosis, aneurysm of the outflow vein and the development of thrombosis, between the presence of concomitant diseases of the peripheral arteries and the development of steal syndrome and stenosis of the inflow artery and the anastomosis zone.Conclusion. Duplex ultrasound allows to diagnose complications of vascular access for hemodialysis and determine its causes.

MILLER Banding Procedure for Treatment of Dialysis Access–Related Steal Syndrome, Pulmonary Hypertension, and Heart Failure

2021 ◽  
pp. 000313482110562
Author(s):  
Ahmad Alqassieh ◽  
Patrick B. Dennis ◽  
Veena Mehta ◽  
June Shi ◽  
Angello Lin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Vascular Access ◽  
Primary Patency ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Long Term Follow Up ◽  
Steal Syndrome

A Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) banding procedure has been used for treating patients with dialysis access–related steal syndrome (DASS) and high-flow vascular access–related pulmonary hypertension (PHT) and heart failure (HF). We performed a retrospective analysis of patients undergoing the MILLER procedure performed for DASS, HF, and PHT from our Vascular Access Database from September 2017 to October 2019. Outcomes included primary patency of banding, primary assisted patency, and secondary patency, using time-to-event analyses with Kaplan-Meier curves and life tables to estimate 6- and 12-month rates. A total of 13 patients (6 men and 7 women, mean age 60 ± 14 years) underwent the MILLER procedure, 6 patients for DASS and 7 patients for pulmonary hypertension and heart failure (PHT/HF). Technical success was achieved in all patients. The longest duration of follow-up was 28 months (median 12 months [IQR 7, 19]). One patient died at 1 month after the intervention due to stroke. One patient developed access thrombosis of the graft 3 days after the procedure. Repeat banding was required in 1 patient 8 months after the first procedure. The 6-month primary patency rate of banding following this procedure was 83% while the 12-month rate was 66%. The 6- and 12-month secondary patency rates were 87% and 75%, respectively. The MILLER procedure can be performed for DASS and PHT/HF with improvement of symptoms and good long-term patency rates. Additional interventions to maintain patency and efficacy are required on long-term follow-up.

Proximal Radial Artery Ligation after Distalization of a High flow Brachio-Cephalic Fistula. A Novel Approach to Inflow Reduction

2008 ◽  
Vol 9 (4) ◽  
pp. 291-292 ◽  
Author(s):  
J.B. Smith ◽  
F.R. Calder
Keyword(s):  
Radial Artery ◽  
Vascular Access ◽  
High Flow ◽  
Artery Ligation ◽  
Novel Technique ◽  
Novel Approach ◽  
Brachiocephalic Fistula

High flow fistulae present a common challenge to vascular access (VA) surgeons and many strategies have been described, each with their benefits and limitations. There are no NK-DOQI guidelines for the management of high flow fistulae or indeed the management of those refractory to more conventional approaches. We discuss a novel technique to inflow reduction in a previously distalized brachiocephalic fistula and recommend the technique of proximal radial artery ligation.

scholarly journals Distal Revascularisation with Interval Ligation (DRIL): An Experience

2009 ◽  
Vol 91 (5) ◽  
pp. 394-398 ◽  
Author(s):  
M Field ◽  
J Blackwell ◽  
A Jaipersad ◽  
M Wall ◽  
MA Silva ◽  
...  
Keyword(s):  
Vascular Access ◽  
International Studies ◽  
Rest Pain ◽  
Basilic Vein ◽  
Central Lines ◽  
Arteriovenous Fistulas ◽  
Number Of Patients ◽  
Digital Pulse ◽  
Global Increase ◽  
Steal Syndrome

INTRODUCTION The global increase of chronic renal failure has resulted in a growing number of patients on haemodialysis using arteriovenous fistulas (AVFs). By virtue of their very function, AVFs at times shunt blood away from regions distally, resulting in an ischaemic steal syndrome. Distal revascularisation with interval ligation (DRIL) has been described as a procedure to treat symptomatic ischaemic steal. We present our experience in the management of this complication. PATIENTS AND METHODS Six patients with severe ischaemic steal were treated using a DRIL procedure between May 2004 and June 2007. There were three males and three females, all with elbow brachiocephalic AVFs. Symptoms ranged from severe rest pain to digital gangrene. Published results from international studies of 135 DRIL procedures were also reviewed. RESULTS Vascular access was maintained along with the elimination of ischaemic symptoms in the six patients using an ipsilateral reversed basilic vein graft. Interval ligation of the distal brachial artery was performed at the same time. All patients showed immediate and sustained clinical improvement of symptoms with a demonstrable increase in digital pulse oximetry. CONCLUSIONS DRIL is a beneficial treatment option that has proven successful at alleviating ischemic steal symptoms and preserving vascular access. This avoids placement of central lines, its associated risks, and the need to create an alternative sited fistula.

Doppler Ultrasonography-Guided Surgery for High-Flow Hemodialysis Vascular Access: Preliminary Results

2008 ◽  
Vol 40 (1) ◽  
pp. 87-89 ◽  
Author(s):  
G. Tellioglu ◽  
I. Berber ◽  
G. Kılıcoglu ◽  
P. Seymen ◽  
M. Kara ◽  
...  
Keyword(s):  
Vascular Access ◽  
Doppler Ultrasonography ◽  
High Flow ◽  
Preliminary Results ◽  
Guided Surgery ◽  
Hemodialysis Vascular Access

One-Year Efficacy of the RUDI Technique for Flow Reduction in High-Flow Autologous Brachial Artery-Based Hemodialysis Vascular Access

2015 ◽  
Vol 16 (9_suppl) ◽  
pp. S96-S101 ◽  
Author(s):  
Roel H.D. Vaes ◽  
Magda van Loon ◽  
Selma M.M. Vaes ◽  
Philippe Cuypers ◽  
Jan H. Tordoir ◽  
...  
Keyword(s):  
Vascular Access ◽  
Brachial Artery ◽  
High Flow ◽  
Flow Reduction ◽  
Hemodialysis Vascular Access ◽  
One Year

scholarly journals Effectiveness of surgical banding for high flow in brachial artery-based hemodialysis vascular access

2015 ◽  
Vol 61 (3) ◽  
pp. 762-766 ◽  
Author(s):  
Roel H.D. Vaes ◽  
Rosanne Wouda ◽  
Magda van Loon ◽  
Frank van Hoek ◽  
Jan H. Tordoir ◽  
...  
Keyword(s):  
Vascular Access ◽  
Brachial Artery ◽  
High Flow ◽  
Hemodialysis Vascular Access

scholarly journals A case report of subclavian steal syndrome caused by high flow radiocephalic arterio venous fistula

2009 ◽  
Vol 42 (7) ◽  
pp. 529-534 ◽  
Author(s):  
Fumiaki Kumagai ◽  
Takahisa Kushida ◽  
Ruka Sasaki ◽  
Masamichi Kondo ◽  
Shigeki Yura ◽  
...  
Keyword(s):  
Case Report ◽  
High Flow ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Venous Fistula ◽  
Steal Syndrome

scholarly journals The importance of ultrasonography in surgical treatment of vascular access for hemodialysis complications

2021 ◽  
Vol 8 (4) ◽  
pp. 18-26
Author(s):  
Tatyana V. Zahmatova ◽  
Valeriia S. Koen ◽  
Kristina S. Anpilogova
Keyword(s):  
Surgical Treatment ◽  
Vascular Access ◽  
Duplex Ultrasound ◽  
Upper Extremities ◽  
Surgical Interventions ◽  
Significant Stenosis ◽  
Laboratory Examinations ◽  
Vein Stenosis ◽  
Design And Methods ◽  
Steal Syndrome

Background. Most complications of vascular access for hemodialysis require surgical treatment and if ineffective lead to fistula loss and depletion of the vascular resource for the new fistula creation.Objective. To identify complications of permanent vascular access for hemodialysis which require surgical treatment and evaluate its results using duplex scanning.Design and methods. Ultrasonography, clinical and laboratory examinations were performed in 550 patients undergoing hemodialysis.Results. Complications of vascular access for hemodialysis were detected in 154 (28.0 %) patients, surgical treatment was performed in 96 (62.3 %) patients. The main indications for surgical treatment were: significant stenosis, occlusive thrombosis, non-occlusive thrombosis in combination with significant vein stenosis, aneurysm with increased access flow, ischemic steal syndrome of the hand and pulsating hematoma. The analysis of surgical interventions showed that the creation of a new access was more often performed (41.7 %) compared to other types of fistula reconstructions which leads to a decrease in the number of vessels in the upper extremities that can be used to create access in the future.Conclusion. Duplex ultrasound allows diagnosing vascular access for hemodialysis complications and evaluating the results of their surgical treatment.

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