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

Abstract

RUDI effectively reduces access flow in a brachial artery-based high-flow HD vascular access. A flow-reducing effect is sustained at 1-year follow-up in most patients. GSV is preferred as an interposition graft compared to a BaV.

A comparison of revision using distal inflow and distal revascularization-interval ligation for the management of severe access-related hand ischemia

“…Multiple studies have demonstrated good preliminary results with the RUDI for the management of high-output heart failure alone or combined with ARHI. 29,31,33 Although more limited, reported RUDI outcomes for ARHI show acceptable patency and symptom resolution and corroborate well with the findings of this series.…”

“…The decision to proceed with RUDI should factor in the burden of distal disease and the technical feasibility of distalization of the anastomosis before creation. Although most reports of the RUDI advocate for the use of autologous tissue for construction, 14,19,25,33 a high proportion of ePTFE was used in the RUDI cohort (75%) in this series. Ring-reinforced ePTFE was used predominantly in an effort prevent kinking of the reconstruction across the elbow joint, and its use in this configuration has been previously described.…”

“…There have been few published studies on patency and clinical outcomes for the RUDI procedure, and a summary of these findings is included in Table II. 3,14,19,25,[29][30][31][32][33] The current existing evidence for the RUDI is confounded by significant heterogeneity in the index access (fistula or graft), RUDI conduit, operative technique, operative indications, and outcome measures. Multiple studies have demonstrated good preliminary results with the RUDI for the management of high-output heart failure alone or combined with ARHI.…”

Three Year Patency and Recurrence Rates of Revision Using Distal Inflow with a Venous Interposition Graft for High Flow Brachial Artery Based Arteriovenous Fistula

“…One year results of some of the patients who underwent RUDI using different interposition grafts (n ¼ 13) have been published previously. 15 In the present cohort, RUDI was performed for three types of upper arm HFAs (brachiocephalic, BC-AVF; brachiobasilic, BB-AVF; Gracz-AVF).…”

“…14 RUDI effectively reduced flow after 1 year follow up, unless a basilic vein interposition graft was used. 15 Long-term efficacy and patency are unknown. The present study aimed to report on 3 year RUDI patency and recurrence rates for HFA with or without HAIDI using GSV interposition.…”