Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access
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...
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| Veröffentlicht in: | Journal of vascular surgery 2010-08, Vol.52 (2), p.495-498 |
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| container_title | Journal of vascular surgery |
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| creator | Shemesh, David, MD Goldin, Ilya, MD Olsha, Oded, MBBS |
| description | 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. |
| doi_str_mv | 10.1016/j.jvs.2010.01.096 |
| format | Article |
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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.</description><subject>Adult</subject><subject>Aged</subject><subject>Arteriovenous Shunt, Surgical - adverse effects</subject><subject>Blood Pressure</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Ischemia - diagnosis</subject><subject>Ischemia - etiology</subject><subject>Ischemia - physiopathology</subject><subject>Ischemia - surgery</subject><subject>Middle Aged</subject><subject>Punctures</subject><subject>Regional Blood Flow</subject><subject>Renal Dialysis</subject><subject>Reoperation</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler, Color</subject><subject>Upper Extremity - blood supply</subject><subject>Vascular Patency</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo7uzqB_AiuXnqsZL-GwTBXVwVFjyo55BJV69pu5MxlZ5l8MubZkYPHrwkVPHeo-pXjL0QsBUgmtfjdjzQVkKuQWxBNY_YRoBqi6YD9ZhtoK1EUUtRXbBLohFAiLprn7ILCWVXV025Yb-uje-dv-c7TA-InvfOTEdyxPeLt2mJyMklJJ4CTxFN4oQHzF1H9jvOznJKaCZOR9_HMOe-51N44MP6mCWFe_RhIW5iwujC4VxZi0TP2JPBTITPz_8V-3b7_uvNx-Lu84dPN-_uClvVkApllNmpoe1M2wgsrRmsKQcJUmKDnTLYthVi3TeqlQKVVKZRlRh6a3tTYteVV-zVKXcfw88FKek5T4_TZDzmaXRbKRAZSZmV4qS0MRBFHPQ-utnEoxagV-R61Bm5XpFrEDojz56X5_RlN2P_1_GHcRa8OQkw73hwGDVZh95i7yLapPvg_hv_9h-3nZx31kw_8Ig0hiX6DE8LTVKD_rLefD25AADZCFn-BvSBqjk</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Shemesh, David, MD</creator><creator>Goldin, Ilya, MD</creator><creator>Olsha, Oded, MBBS</creator><general>Mosby, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100801</creationdate><title>Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access</title><author>Shemesh, David, MD ; Goldin, Ilya, MD ; Olsha, Oded, MBBS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-9a9ab9f78a761e3cafca3f2022e6e89ae774ee5d69721e929a6941fdccda3e883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arteriovenous Shunt, Surgical - adverse effects</topic><topic>Blood Pressure</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Ischemia - diagnosis</topic><topic>Ischemia - etiology</topic><topic>Ischemia - physiopathology</topic><topic>Ischemia - surgery</topic><topic>Middle Aged</topic><topic>Punctures</topic><topic>Regional Blood Flow</topic><topic>Renal Dialysis</topic><topic>Reoperation</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler, Color</topic><topic>Upper Extremity - blood supply</topic><topic>Vascular Patency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shemesh, David, MD</creatorcontrib><creatorcontrib>Goldin, Ilya, MD</creatorcontrib><creatorcontrib>Olsha, Oded, MBBS</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shemesh, David, MD</au><au>Goldin, Ilya, MD</au><au>Olsha, Oded, MBBS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>52</volume><issue>2</issue><spage>495</spage><epage>498</epage><pages>495-498</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>Dialysis-associated steal syndrome with rest pain and ischemic nonhealing ulcers dictates prompt surgical intervention. 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| fulltext | fulltext |
| identifier | ISSN: 0741-5214 |
| ispartof | Journal of vascular surgery, 2010-08, Vol.52 (2), p.495-498 |
| issn | 0741-5214 1097-6809 |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Arteriovenous Shunt, Surgical - adverse effects Blood Pressure Hemodynamics Humans Ischemia - diagnosis Ischemia - etiology Ischemia - physiopathology Ischemia - surgery Middle Aged Punctures Regional Blood Flow Renal Dialysis Reoperation Severity of Illness Index Surgery Treatment Outcome Ultrasonography, Doppler, Color Upper Extremity - blood supply Vascular Patency |
| title | Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access |
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