Arteriovenous access banding revisited

Teixeira, Gabriela; Almeida, Paulo; Sousa, Clemente Neves; Teles, Paulo; Sousa, Paulo De; Loureiro, Luís; Teixeira, Sérgio; Rego, Duarte; Almeida, Rui; Matos, António Norton de

doi:10.5301/jva.5000699

Cited by 16 publications

(14 citation statements)

References 27 publications

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“…Both techniques are minimally invasive procedures. 51,80,82,83 Although successful endovascular banding has been reported in patients with a prosthetic graft, it can be problematic. The walls of a prosthetic graft are not flexible and may fold into the lumen creating a potential problem.…”

Section: Upper Arm Vascular Accessmentioning

confidence: 99%

ASDIN white paper: Assessment and management of hemodialysis access-induced distal ischemia by interventional nephrologists

et al. 2019

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IntroductionHemodialysis access-induced distal ischemia (HAIDI) has been reported to have an incidence of 1%-8%. 1 However, this is based on referred cases requiring surgical treatment. Its true frequency is dependent upon the symptom threshold used to qualify for the diagnosis. Systematic patient evaluation has shown that mild to moderate symptoms occur much more frequently. 2 The reported incidence relates to the upper extremity and is the topic of this review. Access-related distal ischemia can also involve the lower extremity with serious consequences. 3,4 An understanding of HAIDI and the appropriate role of the interventional nephrologist in its management is important when patients present with symptoms suggestive of HAIDI. Herein, the pathophysiology of the syndrome is discussed followed by recommendations for its diagnosis and management and the basis for the recommendations. These recommendations ASDIN white paper: Assessment and management of hemodialysis accessinduced distal ischemia by interventional nephrologists AbstractAlthough not common, hemodialysis access-induced distal ischemia is a serious condition resulting in significant hemodialysis patient morbidity. Patients with signs and symptoms suggestive of hand ischemia frequently present to the general and interventional nephrologist for evaluation. In order to care for these cases, it is necessary to understand this syndrome and its management. Most cases can be managed conservatively without intervention. Some cases requiring intervention may be treated using techniques within the scope of practice of the interventional nephrologists while other cases require vascular surgery. In order for the interventional nephrologists to evaluate and manage these cases in a timely and appropriate manner, practice guidelines are presented.

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Section: Upper Arm Vascular Accessmentioning

confidence: 99%

ASDIN white paper: Assessment and management of hemodialysis access-induced distal ischemia by interventional nephrologists

et al. 2019

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“…Several guidelines recommend that patients with ESRD should be educated on how to take care of their own AVF (NKF-K/DOQI, 2006; Tordoir et al, 2007;Kukita et al, 2015;Ibeas et al, 2017;Schmidli et al, 2018). Some studies have shown that patients generally do not carry out those behaviors required to prevent infection of the AVF, preserve its functioning and identify signs and symptoms of distal hypoperfusion (Pessoa & Linhares, 2015;Ozen et al, 2017;Sousa et al, 2017Sousa et al, , 2020Teixeira et al, 2017). Furthermore, a number of studies have also shown that patients have little or almost no knowledge on AVF care and, in fact, the proportion of such patients can reach nearly 98% (Pessoa & Linhares, 2015).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients

et al. 2020

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This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) ( n = 48) or to a control group (CG) ( n = 41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p < .001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p = .004) and the prevention of complications (72.7% and 89.5%, respectively, p < .001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.

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“…Since the 1970s, banding the access has been the preferred treatment in these cases. Since then, new surgical techniques have been developed 4,5,6 , aiming to achieve the same benefits, such as the Distal Revascularization with Interval Ligation (DRIL), creation of a more proximal arteriovenous anastomosis (PAVA), or the Revision Using Distal Inflow (RUDI). Minimally Invasive limited ligation endoluminal-assisted revision (MILLER) is a more recent endovascular procedure that uses an angioplasty balloon of a selected size to create a "functional stenosis" within the anastomosis and gain a defined reduction in the vessel diameter.…”

Section: Discussionmentioning

confidence: 99%

A modified banding technique: experience of a center

et al. 2021

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Background: A well-functioning vascular access is vital to patients on regular hemodialysis. Banding the access is indicated in high-flow-associated steal syndrome. It allows for the reduction of access flow while maintaining distal limb perfusion. Nonetheless, this procedure has some limitations as it can cause hemorrhage, infection, aneurysm formation, thrombosis of access in cases of overbanding, or otherwise insufficient reduction of vascular flow. Other surgical techniques to achieve the same benefit would be useful. Methods: We performed a modified banding technique without endovascular placement of the angioplasty balloon, which is a viable alternative to other techniques. This surgery was performed in patients on chronic dialysis with steal syndrome. Pre- and post-operative access flows were measured and resolution of symptoms was recorded. Primary patency rate was defined as the intervention-free access survival from the operative time. Results: We verified that this technique allowed for access flow reduction in all our six patients, with total resolution of symptoms in all patients. Primary patency rate at 12 months was 100%. No major complications were noted during our follow-up. Conclusions: This technique allows for correction of high-flow arteriovenous fistulas in an efficient and safe way, and can be a viable alternative to other banding procedures.

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Arteriovenous access banding revisited

Abstract: Our results do not corroborate the high incidence of thrombosis previously reported as associated with AV access banding and suggest that ultrasound control is crucial for preventing technical failure. The procedure was effective on both compared groups.

Cited by 16 publications

References 27 publications

ASDIN white paper: Assessment and management of hemodialysis access-induced distal ischemia by interventional nephrologists

ASDIN white paper: Assessment and management of hemodialysis access-induced distal ischemia by interventional nephrologists

Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients

A modified banding technique: experience of a center

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