Evaluation of patency following revision technique ofhigh-velocity arteriovenous fistula

Authors: ÜMİT HALICI, MEHMET ALİ KAYGIN, ÖZGÜR DAĞ, AHMET AYDIN, HÜSNÜ KAMİL LİMANDAL, ÜMİT ARSLAN, EYÜP SERHAT ÇALIK, BİLGEHAN ERKUT

Abstract: Background/aim: The objective of this study is to report our experience with surgical revision of dialysis access-induced ischemia syndrome. Materials and methods: Between January 2005 and July 2013, 1254 patients underwent arteriovenous fistula operation, and 86 of them [53 males, mean age: 55 ± 25 (range: 25 to 75) years; 33 females, mean age: 50 ± 20 (range: 30 to 70) years] subsequently developed steal syndrome. These patients were treated with arterial pressure-controlled polytetrafluoroethylene banding or constriction with polypropylene suturing technique. Patients were followed in the outpatient clinic at regular intervals. Results: Symptoms were not relieved during the first 15 days in 4 patients; therefore, reintervention was performed. Thrombosis occurred in one patient after reintervention. No early or late complications were detected in other patients, and fistulae were suitable for hemodialysis. Patency rates at 6 and 12 months were 96% and 92%, respectively, and thrombosis rates were 7% and 9%. There was no hospital mortality in our study, but one patient died from unrelated causes and two other patients quit follow-up after 6 months. Conclusion: We think that arterial pressure-controlled surgical revision is an effective and safe technique in patients with fistula-related hand ischemia.

Keywords: Hemodialysis, arteriovenous fistula, hand ischemia, banding technique

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