Arterial insufficiency in hemodialysis access procedures: Reconstruction by an interposition polytetrafluoroethylene graft conduit

West, John C; Evans, R L; Kelley, Stephen E.; Burns-Morrison, Barbara; Campbell, Patricia; Harostock, Michael; Cross, Caroline

doi:10.1016/0002-9610(87)90610-6

Cited by 37 publications

(23 citation statements)

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“…Another technique that has been used is elongation of the BAVF [15]. The purpose of this procedure is also to increase peripheral resistance of the fistula outflow, and it has the same difficulties as banding.…”

Section: Resultsmentioning

confidence: 99%

“…It consists of producing a ste nosis in the outflow portion of the AVF/ BAVF, close to the anastomosis. Many varia tions of banding, all intended to produce a narrowing and consequent flow reduction, have been reported [10][11][12][13][14], Manufacturers are producing grafts de signed to prevent the steal phenomena. These grafts are tapered, and the narrowest portion is intended to be anastomosed to the artery.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Pathogenesis and Management of Upper-Extremity Ischemia following Angioaccess Surgery

Haimov

Schanzer²,

Skladani³

1996

Blood Purif

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Thirty-four patients with end-stage renal disease requiring hemodialysis developed over the course of 7 years (1987-1994) severe ischemia in the extremity carrying the angioaccess secondary to arterial ‘steal’. Seven of these patients were treated with access ligation, 4 with banding reducing the flow through the access, and 23 with ligation of the artery distal to the inflow of the arteriovenous fistula and establishing of an arterial bypass from a point 5 cm proximal to the fistula to the distal artery. Of the 7 patients who underwent ligation, 5 had complete resolution of symptoms, 1 had persistent pain, and 1 patient had residual ischemic neuropathy. Of the 4 patients who underwent banding, 3 lost their access due to thrombosis shortly after the banding procedure, and in 1 patient partial resolution of symptoms was achieved. Of the 23 patients who underwent arterial ligation-bypass procedure, all showed immediate signs of improvement. One patient who presented with advanced gangrene eventually required amputation, and 3 patients had some residual symptoms. The cumulative patency of the access with this procedure was 73% at 1 year and 45.5% at 2 years. The patency for the bypass was 95.6% at 1 and 2 years. The arterial ligation-bypass procedure is currently the treatment of choice for patients developing severe ischemia secondary to ‘steal’ following construction of an arteriovenous fistula for dialysis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pathogenesis and Management of Upper-Extremity Ischemia following Angioaccess Surgery

Haimov

Schanzer²,

Skladani³

1996

Blood Purif

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“…Another option is the insertion of a graft after the AV anastomosis disconnecting between the brachial artery and eff erent vein in the forearm subcutis 38 . In a number of instances, mainly in diabetic patients with severe ischemic changes in the extremity peripheries, the request for saving the fi stula cannot be met, and the only possibility is ligation of the arteriovenous access.…”

Section: Autogenous Arteriovenous Elbow Fi Stula For Haemodialysis Anmentioning

confidence: 99%

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Bachleda¹,

Utíkal²,

Kojecký³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background:The autogenous brachiocefalic or brachiobasilic arteriovenous elbow fi stula is not considered to be only the secondary haemodialysis access. In patients with an unsuitable forearm vessel bundle, it is indicated as primary access and it is the method preferred to the fi stula creation using a vascular prosthesis. Its rather rare complication is the development of upper extremity ischemia.Aim: To summarise current knowledge of this fi stula type and its associated complications Methods: Review of the literature. Results:The creation and maturation of the fi stula and occurrence of the steal syndrome is infl uenced by a number of factors. The analysis and awareness of such factors will provide for creation of a suitable fi stula as well as for timely complication diagnostics and treatment.Conclusions: The autogenous elbow fi stula utilising the brachial artery and the cephalic or basilic vein in the upper extremity represents a high-quality haemodialysis access. Its potential complication is the occurrence of the steal syndrome. Its occurrence and manifestations do not constitute indications for ligation of the access. The gathered information shows that a suitable surgical procedure can help meet the basic rule for haemodialysis access -resolving the ischemia and maintaining the access.

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“…It consists of producing a stenosis in the outflow portion of the AVF, close to the anastomosis. Many variations of banding, all intended to produce a narrowing and consequent flow reduction, have been reported (6)(7)(8). The practical problem in banding technique stems from the diffulty in establishing the precise degree of stenosis required for elimination of the steal, while allowing a flow sufficient to sustain patency of the outflow fistula.…”

Section: R Re Es Su Ul Lt Ts Smentioning

confidence: 99%

Correction of Steal Syndrome of Native Arterivenous Fistulas in Hemodialysis Patients by ‘‘Banding’’ Technique

Özışık¹

2003

Journal of Ankara Medical School

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Arterial insufficiency in hemodialysis access procedures: Reconstruction by an interposition polytetrafluoroethylene graft conduit

Cited by 37 publications

References 0 publications

Pathogenesis and Management of Upper-Extremity Ischemia following Angioaccess Surgery

Pathogenesis and Management of Upper-Extremity Ischemia following Angioaccess Surgery

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Correction of Steal Syndrome of Native Arterivenous Fistulas in Hemodialysis Patients by ‘‘Banding’’ Technique

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