Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia

Objective: Vascular access induced digital ischaemia is an uncommon complication of haemodialysis access procedures and is difficult to manage. Several techniques have been described to treat this phenomenon, with variable long term success. Although all of these procedures have been shown to work,...

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Autores principales:	Yana Etkin, Jeffrey Silpe, Firas F. Mussa, Sonia Talathi, Melissa Garuthara, Gregg S. Landis
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Dialysis access Fistula banding Vascular access induced ischaemia Diseases of the circulatory (Cardiovascular) system RC666-701 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/7b66a5ac935149b8bb9fd74b633bbc48
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spelling	oai:doaj.org-article:7b66a5ac935149b8bb9fd74b633bbc482021-11-22T04:32:57ZModified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia2666-688X10.1016/j.ejvsvf.2021.10.017https://doaj.org/article/7b66a5ac935149b8bb9fd74b633bbc482021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666688X21000563https://doaj.org/toc/2666-688XObjective: Vascular access induced digital ischaemia is an uncommon complication of haemodialysis access procedures and is difficult to manage. Several techniques have been described to treat this phenomenon, with variable long term success. Although all of these procedures have been shown to work, they have a significant failure rate, such as persistent high vascular access flow or loss of access. One of the major technical limitations of these techniques is the lack of quantitative data gathered during the procedure to ensure treatment success. In this study, the aim was to describe a novel technique that can improve the success of banding in preserving access and eliminating digital ischaemia. Technique: A modified method for arteriovenous fistula banding that incorporates measurements of distal arterial pressure to improve the success of the procedure is described. Results: Sixteen patients with vascular access induced digital ischaemia and high-flow vascular access were treated using the technique. All procedures were technically successful. At 30 days, complete symptomatic relief (clinical success) was seen in 81% (n = 13) of patients. There was no access thrombosis or infection in any of the patients at the 30 day follow up. Six month follow up data were available in seven patients. There was no loss of access patency or recurrence of symptoms observed at six months. Conclusion: This novel technique is simple and effective and can be used safely as first line therapy for the management of vascular access induced digital ischaemia.Yana EtkinJeffrey SilpeFiras F. MussaSonia TalathiMelissa GarutharaGregg S. LandisElsevierarticleDialysis accessFistula bandingVascular access induced ischaemiaDiseases of the circulatory (Cardiovascular) systemRC666-701SurgeryRD1-811ENEJVES Vascular Forum, Vol 53, Iss , Pp 26-29 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dialysis access Fistula banding Vascular access induced ischaemia Diseases of the circulatory (Cardiovascular) system RC666-701 Surgery RD1-811
spellingShingle	Dialysis access Fistula banding Vascular access induced ischaemia Diseases of the circulatory (Cardiovascular) system RC666-701 Surgery RD1-811 Yana Etkin Jeffrey Silpe Firas F. Mussa Sonia Talathi Melissa Garuthara Gregg S. Landis Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
description	Objective: Vascular access induced digital ischaemia is an uncommon complication of haemodialysis access procedures and is difficult to manage. Several techniques have been described to treat this phenomenon, with variable long term success. Although all of these procedures have been shown to work, they have a significant failure rate, such as persistent high vascular access flow or loss of access. One of the major technical limitations of these techniques is the lack of quantitative data gathered during the procedure to ensure treatment success. In this study, the aim was to describe a novel technique that can improve the success of banding in preserving access and eliminating digital ischaemia. Technique: A modified method for arteriovenous fistula banding that incorporates measurements of distal arterial pressure to improve the success of the procedure is described. Results: Sixteen patients with vascular access induced digital ischaemia and high-flow vascular access were treated using the technique. All procedures were technically successful. At 30 days, complete symptomatic relief (clinical success) was seen in 81% (n = 13) of patients. There was no access thrombosis or infection in any of the patients at the 30 day follow up. Six month follow up data were available in seven patients. There was no loss of access patency or recurrence of symptoms observed at six months. Conclusion: This novel technique is simple and effective and can be used safely as first line therapy for the management of vascular access induced digital ischaemia.
format	article
author	Yana Etkin Jeffrey Silpe Firas F. Mussa Sonia Talathi Melissa Garuthara Gregg S. Landis
author_facet	Yana Etkin Jeffrey Silpe Firas F. Mussa Sonia Talathi Melissa Garuthara Gregg S. Landis
author_sort	Yana Etkin
title	Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
title_short	Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
title_full	Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
title_fullStr	Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
title_full_unstemmed	Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia
title_sort	modified banding of arteriovenous fistulas for the treatment of vascular access induced digital ischaemia
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/7b66a5ac935149b8bb9fd74b633bbc48
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Modified Banding of Arteriovenous Fistulas for the Treatment of Vascular Access Induced Digital Ischaemia

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