Surgical techniques for haemodialysis access-induced distal ischaemia

The Journal of Vascular Access
Julien Al ShakarchiNicholas Inston

Abstract

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. 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. 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 su...Continue Reading

References

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Feb 6, 2013·Annals of Vascular Surgery·George E SmithIan C Chetter

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Citations

Jul 30, 2020·The Journal of Vascular Access·Gabriela TeixeiraRui Almeida

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Software Mentioned

Ovid Embase
Ovid Medline
RUDI
PRISMA
PAI

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