The MILLER banding procedure is an effective method for treating dialysis-associated steal syndrome
| Autor: | Gregg A. Miller, Alexander Friedman, Yevgeny Savransky, Manish C. Jotwani, Aleksandr Khariton, Naveen Goel, Dean C. Preddie, William Perry Arnold, Konstantin Khariton |
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| Jazyk: | angličtina |
| Předmět: |
Male
Nephrology medicine.medical_specialty medicine.medical_treatment Arteriovenous fistula ischemia Arteriovenous Shunt Surgical Renal Dialysis Internal medicine medicine Humans access flow rate arteriovenous fistula Ligation Dialysis thrombosis Aged Retrospective Studies Vascular disease business.industry Arteriovenous malformation Middle Aged Hand medicine.disease Thrombosis Symptomatic relief Surgery body regions Heart failure dialysis Female business |
| Zdroj: | Kidney International. (4):359-366 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.2009.461 |
| Popis: | We evaluated the efficacy of the Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) banding procedure in treating dialysis-associated steal syndrome or high-flow access problems. A retrospective analysis was conducted, evaluating banding of 183 patients of which 114 presented with hand ischemia (Steal) and 69 with clinical manifestations of pathologic high access flow such as congestive heart failure. Patients were assessed for technical success and symptomatic improvement, primary and secondary access patency, and primary band patency. Overall, 183 patients underwent a combined 229 bandings with technical success achieved in 225. Complete symptomatic relief (clinical success) was attained in 109 Steal patients and in all high-flow patients. The average follow-up time was 11 months with a 6-month primary band patency of 75 and 85% for Steal and high-flow patients, respectively. At 24 months the secondary access patency was 90% and the thrombotic event rates for upper-arm fistulas, forearm fistulas, and grafts were 0.21, 0.10, and 0.92 per access-year, respectively. Hence, the minimally invasive MILLER procedure appears to be an effective and durable option for treating dialysis access-related steal syndrome and high-flow-associated symptoms. |
| Databáze: | OpenAIRE |
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