Open Repair and Venous Inflow Plication of the Arteriovenous Fistula Is Effective in Treating Vascular Steal Syndrome

Dilator-assisted Banding and Beyond: Proposing an Algorithm for Managing Dialysis Access-associated Steal Syndrome

“…The need for repeated banding in some patients as reported (10) might be ascribed to vascular remodeling and limited stenotic nature of ligature banding (9). To minimize this problem in fistulas with large post-arterial anastomosis segments (diameter >15 mm), open fistula reduction plus DAB (o-DAB) as described in this report or endoluminal-guided plication may be utilized to achieve long-lasting result (6, 9, 18). Unlike i-DAB and e-DAB that are easier to perform, o-DAB is a more extensive surgical procedure that requires more surgical skills and expertise.…”

Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER): A Review of the Available Literature and Brief Overview of Alternate Therapies in Dialysis Associated Steal Syndrome

“…Banding and plication are both procedures which rely on increasing the resistance to flow, thereby increasing peripheral perfusion [ 20 , 21 ]. Banding is frequently performed by wrapping a segment of polytetrafluoroethylene (PTFE) around the outflow track of the fistula to create a narrowing.…”

“…Digital pulse oximetry can help in identifying the amount of compression which will yield symptom improvement, but defined criteria guiding the degree of compression are lacking. Previous studies evaluating the banding technique have realized unacceptable thrombosis rates of 19–90% [ 9 , 21 , 22 , 23 ]. Banding is usually reserved for patients with high flow AV accesses.…”

“…The degree of narrowing is guided by return of palpable pulses or dopplerable signals. Recent limited series have shown promise with success rates of 92–100% with revision rates of 14–20% [ 21 , 24 ]. Further, more robust, series are needed before this procedure becomes widely adopted.…”

Plication for the Treatment of a Radio-Cephalic Fistula with Ulnar Artery Steal

“…In 1992 Rivers et al reported on the use of plication under Duplex ultrasound guide in five patients. Rivers et al believe that a 5 mm increase in pulse volume recordings is necessary to obtain the resolution of the steal syndrome (13), and in 2015 Patil et al reported a case series of high-flow proximal AVF treated successfully with plication with a 12% revision rate and 92% symptom resolution while maintaining a working access (14). On the contrary, Khalil et al performed plication, narrowing uniformly the vein lumen to 3 mm, without the intra-operative use of the Duplex ultrasound obtaining satisfactory clinical results only evaluating the radial pulse (15).…”