The increasing use of sophisticated imaging modalities may allow earlier discovery of carotid body tumors before they can be clinically detected. Resection of carotid body tumors of all sizes in appropriate surgical candidates remains the standard of care. Unfortunately, resection of even small tumors is associated with a low but constant incidence of neurologic complications.

The DRIL technique reliably restores antegrade flow to the ischemic limb, eliminates the potential pathway for the steal physiologic mechanism, and maintains continuous dialysis access in these difficult patients.

DRIL is a durable and effective procedure that reliably accomplishes the twin goals in the treatment of angioaccess-induced ischemia: persistent relief of hand ischemia and continued access patency.

In the current series, a 10% improvement in accomplishing or maintaining a functional autogenous access was achieved through secondary procedures applied to autogenous fistulas that either fail to mature or develop functional deterioration. Aggressive assessment of immature or failing autogenous AV fistulas for correctable lesions should be included in any hemodialysis practice to optimize their use and exploit the superiority of the native fistula.

AAV bypasses can provide overall results comparable with SSGSV bypasses.