Treatment of High Flow Arteriovenous Fistulas after Successful Renal Transplant Using a Simple Precision Banding Technique

Gkotsis, Georgios; Jennings, William C.; Malík, Jan; Mallios, Alexandros; Taubman, Kevin

doi:10.1016/j.avsg.2015.08.012

Cited by 45 publications

(44 citation statements)

References 21 publications

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“…Paradoxically, patients with active AVF and the worst renal graft function in the whole study group presented the highest proportion of subjects willing to ligate their vascular access ( Fig 1 ). Thus, we alarm that there is a clear need for patients' education in order to raise awareness of the possible AVF management strategies, including not only ligation but also banding or flow-reduction [ 29 , 30 ], by providing thorough and evidence-based information source. In our study, the main source of knowledge of AVFs in the investigated patient cohort remains unspecified.…”

Section: Discussionmentioning

confidence: 99%

The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation

et al. 2020

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Background Arteriovenous fistulas (AVF) are a source of various complications. Among previously hemodialyzed kidney transplant recipients (KTxR), the AVF may persist over time. The patients' decisions whether to ligate the functioning AVF may be prompted by many factors. Our knowledge of benefits concerning the procedure as well as patients' attitude towards it is scarce. Aim Evaluation of the patients' opinion on the persistent AVF ligation after a successful kidney transplantation. Materials and methods An anonymous survey was carried out among 301 previously hemodialyzed KTxR. The patients were recruited during scheduled visits in the Transplantation Outpatient Unit. All subjects completed an anonymous questionnaire including questions about their attitude towards the matter in question. Results 69 patients (22.9%) have considered AVF closure. The most common causes for such attitude were esthetic reasons (n = 29) and concerns about heart health (n = 13). Among those 69 subjects, 18 have presented with symptomatic AVF due to multiple symptoms. Symptomatic AVFs were localized on the forearm in 14 out of 18 cases. As many as 116 (38.5%) cases have never wanted to ligate the AVF and 116 (38.5%) subjects did not have a clear opinion. In our study we report 158 (52.5%) cases of non-functioning AVFs. The main reason for the above was spontaneous AVF thrombosis (121 cases). Only 24 subjects reported to rely on the physician-provided information about the AVF management.

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Section: Discussionmentioning

confidence: 99%

The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation

et al. 2020

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“…Failure of flow reduction by banding may be associated with limited precision and inadequate or excessive diameter reductions based on "best-guess or eyeball" assessment. The use of intraoperative ultrasound flow measurements before and after banding and adjusting the restriction in ½ mm increments allows precise adjustment and superior flow restriction outcomes (4).…”

Section: Discussionmentioning

confidence: 99%

A mechanism of banding failure in excessively dilated fistulas

2018

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Identical findings in these four patients suggest that the extensive infolding and caliber diameter reduction created by banding these massively dilated fistulas, when combined with the pulsatility induced in the pre-banding segment, leads to a gradual incorporation of the suture tie into the vessel wall and finally within the lumen. We suggest erosion of banding material and failure of flow reduction may occur with any technique but may be more likely with a single polypropylene suture restricting very large AVF. We suggest such excessively dilated fistulas requiring flow reduction may be successfully treated by reconstruction of the AVF anastomosis to a much smaller size with tapering of the outflow vein to accommodate the revision.

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“…Dilator-assisted banding is a simple and effective guided fistula flow reduction approach that we described previously. 17,26,27 The reported clinical outcomes of basilic vein transposition vary widely in the literature. 3,[8][9][10]14 The definitions and calculations of the fistula patency rates in the reports differed significantly.…”

Section: Discussionmentioning

confidence: 99%

Basilic elevation transposition may improve the clinical outcomes for superficialization of basilic arteriovenous fistula veins

Wang

Jennings

2017

Journal of Vascular Surgery

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Treatment of High Flow Arteriovenous Fistulas after Successful Renal Transplant Using a Simple Precision Banding Technique

Cited by 45 publications

References 21 publications

The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation

The attitude of kidney transplant recipients towards elective arteriovenous fistula ligation

A mechanism of banding failure in excessively dilated fistulas

Basilic elevation transposition may improve the clinical outcomes for superficialization of basilic arteriovenous fistula veins

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