Arteriovenous access banding revisited.

Area of Science:

• Vascular Surgery
• Nephrology
• Interventional Radiology

Background:

• High flow access (HFA) and haemodialysis access-induced distal ischaemia (HAIDI) are common complications of arteriovenous (AV) access.
• AV access banding is a potential treatment option for these conditions.

Purpose of the Study:

• To validate the effectiveness and safety of AV access banding for HFA and HAIDI.
• To assess the incidence of complications, particularly thrombosis, associated with the procedure.

Main Methods:

• Retrospective study of 119 patients undergoing AV access banding for HFA or HAIDI.
• Analysis of patient demographics, comorbidities, symptoms, and intraoperative ultrasound findings.
• Definition and tracking of technical failure and complications like thrombosis, rupture, and aneurysm.

Main Results:

• Primary clinical success was achieved in 71.4% of patients, with a secondary success rate of 84.9%.
• The HAIDI group was older and had a higher prevalence of diabetes.
• Older age and intraoperative ultrasound control were significantly associated with primary success.

Conclusions:

• AV access banding is an effective procedure for both HFA and HAIDI.
• The study did not find a high incidence of thrombosis, contrary to previous reports.
• Intraoperative ultrasound control is crucial for preventing technical failure and improving outcomes.