The Banding Method for the Reduction of Blood Flow in Hyperfunctioning Arteriovenous Fistula

Öz

Objective: Ischemic steal syndrome is a critical complication of arteriovenous (AV) fistula for haemodialysis access that can result in limb loss. Prolonged digital or distal ischemia should be prevented with surgical revascularization. In the current study, we sought to investigate outcomes of the Venocuff banding method for such patients. Method: Twenty-two patients with haemodialysis access related ischemia complaints were included in this study. The Venocuff banding method was applied to reduce blood flow in the hyperfunctioning AV fistula. Demographical and postoperative findings were recorded early in the first week and six months after the operation. Findings: There were 16 (73%) male patients and an average age of 64.6 ± 27.3 years. The most commonly accompanying diseases were found to be diabetes mellitus (n:20/90%) and hypertension (n:22/100%). There were 12 (54%) radiocephalic AV fistulas. Preoperative and postoperative Vmax values were found to be -21.3 ± -9.1 cm/s and 24.64 ± 10.45 cm/s, respectively (p = 0.000). Ischemic complaints and findings regressed in the early postoperative period for all patients. Conclusion: The banding method using Venocuff seems to be effective for reducing blood flow in hyperfunctioning AV fistula and ameliorating ischemic complaints.

Anahtar Kelimeler

• Hyperfunctioning AV fistula
• Ischemic steal syndrome
• Venocuff
• Banding

Hiperfonksiyonel Arteriovenöz Fistülde Kan Akışını Azaltmak İçin Bantlama Yöntemi

Öz

Amaç: İskemik çalma fenomeni, hemodiyaliz girişi için arteriovenöz (AV) fistülün uzuv kaybı ile sonuçlanabilen kritik bir komplikasyonudur. Uzamış dijital veya distal iskemi, cerrahi revaskülarizasyon ile önlenmelidir. Bu çalışmada, bu tür hastalar için VenocuffTM bantlama yönteminin sonuçlarını araştırmayı amaçladık. Yöntem: Hemodiyaliz girişine bağlı iskemi şikayeti olan 22 hasta çalışmaya dahil edildi. Hiperfonksiyonel AV fistülde kan akımını azaltmak için Venoocuff bantlama yöntemi uygulandı. Demografik bulgular ve postoperatif bulgular operasyonun 1. haftası başında ve 6. aydan sonra kaydedildi. Bulgular: Yaş ortalaması 64.6 ± 27.3 yıl olan 16 (% 73) erkek hasta vardı. En sık eşlik eden hastalıklar DM (n: 20 /% 90) ve hipertansiyon (n: 22 /% 100) olarak bulundu. 12 (% 54) radyosefalik AV fistül vardı. Preoperatif ve postoperatif Vmax değerleri sırasıyla -21,3 ± -9,1 cm / s ve 24,64 ± 10,45 cm / s olarak bulundu (p = 0,000). Tüm hastalarda postoperatif erken dönemde iskemik yakınmalar ve bulgular geriledi. Sonuç: Venocuff kullanılan bantlama yöntemi, hiperfonksiyonel AV fistülde kan akışını azaltmada ve iskemik şikayetleri iyileştirmede etkili görünmektedir.

Anahtar Kelimeler

• Hiperfonksiyonel AV fistül
• İskemik çalma sendromu
• Venocuff
• Bantlanma

Kaynakça

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