2014
DOI: 10.1503/cjs.000613
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Distal revascularization and interval ligation (DRIL) procedure requires a long bypass for optimal inflow

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Cited by 13 publications
(9 citation statements)
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“…Following AVF creation, the deviation of a part of the arterial blood occurs at the arteriovenous anastomosis level towards the venous side, with low resistance circuit. It has been shown that the decreased pressure appears from approximately 20-25 cm proximal to the anastomosis22425. Vascular resistance is inversely proportional to the diameter of the vessel.…”
Section: Discussionmentioning
confidence: 99%
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“…Following AVF creation, the deviation of a part of the arterial blood occurs at the arteriovenous anastomosis level towards the venous side, with low resistance circuit. It has been shown that the decreased pressure appears from approximately 20-25 cm proximal to the anastomosis22425. Vascular resistance is inversely proportional to the diameter of the vessel.…”
Section: Discussionmentioning
confidence: 99%
“…It has been shown that the decreased digital pressure is not consistently associated with the clinical evidence of ischaemia1, although in some cases, it may cause pain at rest and necrosis, leading to haemodialysis access-induced distal ischaemia (HAIDI) (also known as access-related hand ischaemia, distal hypoperfusion ischaemic syndrome or arterial steal syndrome). A better understanding of the pathophysiological mechanisms involved in HAIDI occurrence is crucial for early detection of the ‘at risk’ patients and it would permit adopting an early therapeutic strategy234.…”
mentioning
confidence: 99%
“…The second bypass acts as a substitute for the occluded artery. Importantly, it is better to intercept the communication between the AVF and palmar circulation like as distal revascularization and interval ligation (DRIL) [4] (Fig. 3).…”
Section: Discussionmentioning
confidence: 99%
“…This results in a “pressure sink” or a gradual diminution in the pressure along the course of the inflow artery. Kopriva et al 31 measured the pressures at intervals along the inflow artery in a series of brachial artery-based AVFs in patients (N=10) with severe ARHI and reported that the pressures were significantly lower than the central pressures until a level of 20 – 25 cm from the anastomosis was reached (i.e. 20 cm proximal to the AVF anastomosis).…”
Section: Discussionmentioning
confidence: 99%