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Abstract

Purpose

Haemodialysis access-induced distal ischaemia (HAIDI) is a significant complication of vascular access creation, and has traditionally been difficult to manage without loss of access. Current treatment options include ligation, banding, distal revascularisation with interval ligation (DRIL), proximalisation of the arterial inflow (PAI) and revision using distal flow (RUDI). The purpose of this review was to evaluate the effectiveness of the different surgical techniques in the treatment of HAIDI.

Methods

Electronic databases were searched for studies assessing surgical techniques in the treatment of HAIDI in accordance with PRISMA. The primary outcome for the study was symptomatic relief for each technique, defined within each study. Secondary outcomes included comparison of early thrombosis rates following each different procedure.

Results

Following strict inclusion/exclusion criteria by two reviewers, twenty-seven studies of surgical interventions were included and divided into subgroups for banding, DRIL, PAI and RUDI procedures. Both DRIL and banding procedures were found to have high rates of symptomatic relief. In addition, the DRIL has a significantly lower rate of early thrombosis than banding although the more recent papers seem to suggest that early thrombosis is less of a problem in banding. PAI and RUDI showed some promise but there were too few studies to be able to make any clear conclusions.

Conclusions

All four procedures have high success rate in relieving ischaemic symptoms with the DRIL procedure having a significantly better vascular access patency rate than other techniques, although further well designed studies are required to compare all four surgical techniques.

Keywords

Access DRIL PAI Banding RUDI

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References

Tordoir

Dammers

van der Sande

Upper extremity ischemia and hemodialysis vascular access.

Eur J Vasc Endovasc Surg 2004;27(1):1–5

Beathard

Spergel

Hand ischemia associated with dialysis vascular access: an individualized access flow-based approach to therapy.

Semin Dial 2013;26(3):287–314

Moher

Liberati

Tetzlaff

Altman

DG;

PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

PLoS Med 2009;6(7):e1000097

Miller

The inverse of the Freeman-Tukey double arcsine transformation.

Am Stat 1978;32:138

Leake

Winger

Leers

Gupta

Makaroun

Dillavou

Dialysis access-associated steal syndrome management and outcomes: a 10-year experience J Vasc Surg.

2014;59(6):32S

Wang

Almehmi

Packer

Dilator-assisted banding for managing complications associated with excessive hemodialysis access flow.

Semin Dial 2013;26(1):100–105

Smith

Barnes

Green

Kuhan

Chetter

ICA

A “Christmas tree” band for the treatment of arteriovenous dialysis access-related steal syndrome.

Ann Vasc Surg 2013;27(2):239 239.e12

Gupta

Yuo

Konig

IV et al.

Treatment strategies of arterial steal after arteriovenous access.

J Vasc Surg 2011;54(1):162–167

Shemesh

Goldin

Olsha

Banding between dialysis puncture sites to treat severe ischemic steal syndrome in low flow autogenous arteriovenous access.

J Vasc Surg 2010;52(2):495–498

10.

Miller

Goel

Friedman

et al.

The MILLER banding procedure is an effective method for treating dialysis-associated steal syndrome.

Kidney Int 2010;77(4):359–366

11.

van Hoek

Scheltinga

Luirink

Pasmans

Beerenhout

Banding of hemodialysis access to treat hand ischemia or cardiac overload.

Semin Dial 2009;22(2):204–208

12.

Thermann

Ukkat

Wollert

Dralle

Brauckhoff

Dialysis shunt-associated steal syndrome (DASS) following brachial accesses: the value of fistula banding under blood flow control.

Langenbecks Arch Surg 2007;392(6):731–737

13.

Schneider

Gawad

Strate

Pfalzer

Izbicki

T-banding: a technique for flow reduction of a hyperfunctioning arteriovenous fistula.

J Vasc Surg 2006;43(2):402–405

14.

Goel

Miller

Jotwani

Licht

Schur

Arnold

Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) for treatment of dialysis access-associated steal syndrome.

Kidney Int 2006;70(4):765–770

15.

Morsy

Kulbaski

Chen

Isiklar

Lumsden

Incidence and characteristics of patients with hand ischemia after a hemodialysis access procedure.

J Surg Res 1998;74(1):8–10

16.

DeCaprio

Valentine

Kakish

Awad

Hagino

Clagett

Steal syndrome complicating hemodialysis access.

Cardiovasc Surg 1997;5(6):648–653

17.

Scali

Chang

Raghinaru

et al.

Prediction of graft patency and mortality after distal revascularization and interval ligation for hemodialysis access-related hand ischemia.

J Vasc Surg 2013;57(2):451–458

18.

Aimaq

Katz

Using distal revascularization with interval ligation as the primary treatment of hand ischemia after dialysis access creation.

J Vasc Surg 2013;57(4):1073–1078 discussion 1078

19.

Anaya-Ayala

Pettigrew

Ismail

et al.

Management of dialysis access-associated “steal” syndrome with DRIL procedure: challenges and clinical outcomes.

J Vasc Access 2012;13(3):299–304

20.

Field

Blackwell

Jaipersad

et al.

Distal revascularisation with interval ligation (DRIL): an experience.

Ann R Coll Surg Engl 2009;91(5):394–398

21.

Huber

Brown

Seeger

Lee

Midterm outcome after the distal revascularization and interval ligation (DRIL) procedure.

J Vasc Surg 2008;48(4):926–932 discussion 932-933

22.

Cook

Canty

McGinn

Taft

Hye

Hemodialysis-related steal syndrome: predictive factors and response to treatment with the distal revascularization-interval ligation procedure.

Ann Vasc Surg 2008;22(2):210–214

23.

Walz

Ladowski

Hines

Distal revascularization and interval ligation (DRIL) procedure for the treatment of ischemic steal syndrome after arm arteriovenous fistula.

Ann Vasc Surg 2007;21(4):468–473

24.

Mwipatayi

Bowles

Balakrishnan

Callaghan

Haluszkiewicz

Sieunarine

Ischemic steal syndrome: a case series and review of current management.

Curr Surg 2006;63(2):130–135

25.

Sessa

Riehl

Porcu

et al.

Treatment of hand ischemia following angioaccess surgery using the distal revascularization interval-ligation technique with preservation of vascular access: description of an 18-case series.

Ann Vasc Surg 2004;18(6):685–694

26.

Korzets

Kantarovsky

Lehmann

et al.

The “DRIL” procedure—a neglected way to treat the “steal” syndrome of the hemodialysed patient.

Isr Med Assoc J 2003;5(11):782–785

27.

Lazarides

Staramos

Kopadis

Maltezos

Tzilalis

Georgiadis

Onset of arterial ‘steal’ following proximal angioaccess: immediate and delayed types.

Nephrol Dial Transplant 2003;18(11):2387–2390

28.

Knox

Berman

Hughes

Gentile

Mills

Distal revascularization-interval ligation: a durable and effective treatment for ischemic steal syndrome after hemodialysis access.

J Vasc Surg 2002;36(2):250–255 discussion 256

29.

Berman

Gentile

Glickman

et al.

Distal revascularization-interval ligation for limb salvage and maintenance of dialysis access in ischemic steal syndrome.

J Vasc Surg 1997;26(3):393–402 discussion 402-404

30.

Thermann

Wollert

Proximalization of the arterial inflow: new treatment of choice in patients with advanced dialysis shunt-associated steal syndrome?

Ann Vasc Surg 2009;23(4):485–490

31.

Zanow

Kruger

Scholz

Proximalization of the arterial inflow: a new technique to treat access-related ischemia.

J Vasc Surg 2006;43(6):1216–1221 discussion 1221

32.

Callaghan

Mallik

Sivaprakasam

Iype

Pettigrew

Treatment of dialysis access-associated steal syndrome with the “revision using distal inflow” technique.

J Vasc Access 2011;12(1):52–56

Surgical Techniques for Haemodialysis Access-Induced Distal Ischaemia

Abstract

Purpose

Methods

Results

Conclusions

Keywords

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