Bridge Graft to a Small Distal Artery after Fistula Ligation for                     Angioaccess-Induced Ischemia: Report of Two Cases

Andrade, Jó Luis; Paschôa, Adilson Ferraz; Bellen, Bonno van

doi:10.1177/112972980400500107

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…A 60% ±18 mean postoperative reduction rate was observed in 35 patients (mean age 44 years, range 2-67 years). Similar technique was reported by a different author in two patients in 2004 (16).…”

Section: Effective Flow Reduction Methodssupporting

confidence: 73%

Access Flow Reduction for Cardiac Failure

Bourquelot

2016

J Vasc Access

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High-flow in hemodialysis arteriovenous angioaccesses is frequent. It may result in high-output cardiac failure, which should be prevented by fistula flow reduction. The most frequently reported flow reduction procedure is banding but immediate and long-term results are questionable. Alternative techniques are related here with personal results. Juxta-anastomosis "Proximal Radial Artery Ligation" (PRAL) is a very simple and effective reduction technique for side-to-end radio-cephalic fistulas (82 patients; reduction rate [RR]: 54% ± 19%). For brachial artery-based fistulas flow reduction two variants of Revision Using Distal Inflow (RUDI) procedures are used: 1) RUDI-1 using a polytetrafluoroethylene (PTFE) graft or a greater saphenous vein, which we first described in 1989 as "Distal Report of the Arterial Inflow" (35 patients; RR: 53% ± 18%), 2) RUDI-2 procedure, "Transposition of the Radial Artery", which we described in 2009 (47 patients; RR: 66% ± 14%).

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Section: Effective Flow Reduction Methodssupporting

confidence: 73%

Access Flow Reduction for Cardiac Failure

Bourquelot

2016

J Vasc Access

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“…For a brachial artery-based HFA, frequently used flow-reducing techniques are banding, RUDI (and its variants) and TRA (Tab. II) (4, 10, 11, 18, 21–25).…”

Section: Discussionmentioning

confidence: 99%

“…Chemla et al studied patients with high-output heart failure undergoing a variant of a RUDI procedure (4). In contrast to the “original” RUDI technique as introduced by Andrade and Minion, he used distal (rather than proximal) portions of a radial artery as inflow source and a 6 mm prosthesis as an interposition graft (11, 21). Access flow (-2.1 L/min) and cardiac output (-2.4 L/min) were greatly attenuated following this inflow revision.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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“…In a patient at high risk for DASS or a history of DASS or ischemic changes, even if a short segment of vein or prosthetic graft is required, a PRA AVF is preferable to a brachial artery AVF. Although autogenous vein is the preferred choice for extension of the AVF vein, excellent outcomes without significant complications have been reported when a segment of 6 mm diameter expanded polytetrafluoroethylene (ePTFE) is used to extend the vein—as long as this segment is not used for cannulation . If it is necessary to use the brachial (or femoral) artery as inflow, the size of the anastomosis should be limited as close to 4 mm as possible to limit the flow.…”

Section: Part 2: Management Of Dialysis Access Steal Syndromementioning

confidence: 99%

Hand Ischemia Associated With Dialysis Vascular Access: An Individualized Access Flow‐based Approach to Therapy

Beathard¹,

Spergel²

2013

Seminars in Dialysis

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With the rise in the median age of hemodialysis patients, the increasing numbers of patients with multiple risk factors for vascular disease, and the efforts being made to increase the creation of autogenous arteriovenous fistulas (AVFs), dialysis access-related steal syndrome (DASS) has become a growing problem. This syndrome, caused by arterial insufficiency distal to the arteriovenous access due to diversion of blood into the access, is a potentially devastating complication. It is crucial that physicians who manage hemodialysis patients and perform vascular access procedures have a comprehensive understanding of the pathophysiology, symptoms, diagnostic maneuvers, and treatment options for DASS. The goals of management must be twofold-relieve the ischemia and preserve the access. The choice of any intervention, if such is necessary, should be based upon the clinical features presented by that individual patient; the clinical condition and prognosis of the patient, stage of the disease, location of the arterial anastomosis, and the level of blood flow within the access. This review presents information that supports an individualized, physiologic approach to this condition.

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Bridge Graft to a Small Distal Artery after Fistula Ligation for Angioaccess-Induced Ischemia: Report of Two Cases

Cited by 11 publications

References 5 publications

Access Flow Reduction for Cardiac Failure

Access Flow Reduction for Cardiac Failure

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

Hand Ischemia Associated With Dialysis Vascular Access: An Individualized Access Flow‐based Approach to Therapy

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