Document Detail


Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access.
MedLine Citation:
PMID:  20385463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Dialysis-associated steal syndrome with rest pain and ischemic nonhealing ulcers dictates prompt surgical intervention. Distal revascularization with interval ligation is extensive surgery for frail patients in whom calcified distal arteries make anastomosis difficult. Simple banding is appropriate in high-flow fistulas. In low-flow accesses, further flow reduction by simple banding may result in inadequate dialysis and cause thrombosis. However, banding between puncture sites maintains a pressure gradient between the arterial and venous puncture sites that enables adequate flow with effective hemodialysis that would not be possible with banding at the anastomosis. This new technique is a good solution for maintaining access patency and increasing digital pressure while avoiding complicated surgical revisions in high-risk patients.
Authors:
David Shemesh; Ilya Goldin; Oded Olsha
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Publication Detail:
Type:  Journal Article     Date:  2010-04-10
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  52     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  2010-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  495-8     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Surgery, Vascular Access Center, Shaare Zedek Medical Center, Jerusalem, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arteriovenous Shunt, Surgical / adverse effects*
Blood Pressure
Hemodynamics*
Humans
Ischemia / diagnosis,  etiology,  physiopathology,  surgery*
Middle Aged
Punctures
Regional Blood Flow
Renal Dialysis*
Reoperation
Severity of Illness Index
Treatment Outcome
Ultrasonography, Doppler, Color
Upper Extremity / blood supply*
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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