Short interposition with a small-diameter prosthetic graft for flow reduction of a high-flow arteriovenous fistula

Hashimoto, Takeji; Akagi, Daisuke; Yamamoto, Satoshi; Suhara, Masamitsu; Sato, Osamu; Deguchi, Juno

doi:10.1016/j.jvs.2020.05.035

Cited by 10 publications

(17 citation statements)

References 17 publications

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“…[ 15 ] High-flow AVF might cause complications including steal syndrome, venous hypertension, and aneurysmal degeneration in addition to those mentioned above. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Intracranial venous reflux without the central venous occlusive disease in a patient receiving hemodialysis through brachio-brachial arteriovenous fistula: A case report

Ito

Taniguchi

Uemura

et al. 2022

Surgical Neurology International

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Background: Upper-limb arteriovenous fistula as a hemodialysis access among patients with end-stage renal disease (ESRD) has become a preferred type of vascular access. However, complications involving the central nervous system may occur. There have been no reported cases of internal jugular vein (IJV) regurgitation without central venous occlusive diseases (CVODs).We describe the case of a patient on HD who presented with symptomatic IJV regurgitation without CVODs. Case Description: An 83-year-old man with ESRD receiving HD through a left upper-limb AVF presented with impaired consciousness and seizures. After recovery from unconsciousness, he became alert with cognitive impairment. The left subclavian arteriography revealed early filling of the left subclavian vein due to the AVF on the left brachium, with retrograde high-flow venous reflux to the left IJV, sigmoid and transverse sinuses, with the left central veins patent. All cerebral venous drainage procedures were dependent on the right IJV. The left internal carotid arteriography showed venous congestion of the left hemisphere. The flow of the left brachial artery was measured extremely high. Under compression of the left brachial artery to reduce the flow, the regurgitation persisted. With the findings that all cerebral venous return were in the right IJV, sacrificing the left IJV was thought to be acceptable. Left IJV ligation was performed, and the patient’s cognitive function improved. Conclusion: The short-term outcome after IJV ligation may be positive in the patient who was confirmed to have a normal cerebral venous return route independent of the refluxed IJV.

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“…[ 15 ] High-flow AVF might cause complications including steal syndrome, venous hypertension, and aneurysmal degeneration in addition to those mentioned above. [ 10 ]…”

Section: Discussionmentioning

confidence: 99%

Intracranial venous reflux without the central venous occlusive disease in a patient receiving hemodialysis through brachio-brachial arteriovenous fistula: A case report

Ito

Taniguchi

Uemura

et al. 2022

Surgical Neurology International

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“…Hyperfunctioning fistulas predisposes patients to cardiac failure, ventricular remodeling, and VAA formation [ 1 , 2 ]. Consequently, overflow (>1,500-2,000 mL/min) is an indication for flow-restricting procedures, regardless of the presence of DASS [ 6 - 8 ]. Although some consider a low flow of 300 to 400 mL/sec as adequate, normal flow AVAs require different treatment strategies, as moderate flow reduction may cause access thrombosis [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…We considered further stenosis after pseudo-intima creation and additional graft resistance would aid in volume flow reduction. Therefore, we anticipated a diameter reduction between 50% to 75% [ 1 , 6 - 8 , 11 ]. The results were satisfactory, and the patient remained asymptomatic for 6 months.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Dialysis Access Steal Syndrome with Concomitant Vascular Access Aneurysms

Papadoulas¹,

Theodoropoulou

Kouri³

et al. 2022

Vasc Specialist Int

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Limb ischemia is a known complication of vascular access that may appear early postoperatively or after years. Over the last few decades, various techniques based on different physiological mechanisms have been used for treatment. A standardized treatment does not exist, and must be individualized based on the flow volume, and the type and location of the access. True and false vascular access aneurysms are another common complication of arteriovenous fistulas, which develop because of venous hypertension or repeated needling. Evidence in the literature regarding treatment of patients with steal syndrome and concomitant true arteriovenous aneurysms is scarce. A female with a brachiocephalic fistula complicated by steal syndrome and vascular access aneurysms was treated successfully with tapered graft placement and aneurysm exclusion.

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“…There are little data in the literature on short interposition grafts for the treatment of dialysis access steal syndrome. 7 The goal is to restrict flow by narrowing the wide vein lumen. In our case, although we interposed a 6 mm graft, after a month, the diameter would be only 4 mm because the neointima normally covers the wall.…”

Section: Descriptionmentioning

confidence: 99%

“…Prior DSA with correction of critical stenosis is mandatory and can eliminate the steal in many cases. There are little data in the literature on short interposition grafts for the treatment of dialysis access steal syndrome 7. The goal is to restrict flow by narrowing the wide vein lumen.…”

Section: Descriptionmentioning

confidence: 99%

Short interposition grafting for dialysis-access steal syndrome treatment

et al. 2022

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Short interposition with a small-diameter prosthetic graft for flow reduction of a high-flow arteriovenous fistula

Cited by 10 publications

References 17 publications

Intracranial venous reflux without the central venous occlusive disease in a patient receiving hemodialysis through brachio-brachial arteriovenous fistula: A case report

Intracranial venous reflux without the central venous occlusive disease in a patient receiving hemodialysis through brachio-brachial arteriovenous fistula: A case report

Treatment of Dialysis Access Steal Syndrome with Concomitant Vascular Access Aneurysms

Short interposition grafting for dialysis-access steal syndrome treatment

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