Proximal radial artery ligation after distalization of a high flow brachio-cephalic fistula. A novel approach to inflow reduction.
High flow fistulae present a common challenge to vascular access (VA) surgeons and many strategies have been described, each with their benefits and limitations. There are no NK-DOQI guidelines for the management of high flow fistulae or indeed the management of those refractory to more conventional approaches. We discuss a novel technique to inflow reduction in a previously distalized brachiocephalic fistula and recommend the technique of proximal radial artery ligation.
Smith
J B
JB
Department of Renal Surgery and Transplantation, Guys Hospital, London, UK. Julian.Smith@gstt.nhs.uk
Calder
F R
FR
D000328:Adult; D001166:Arteriovenous Shunt, Surgical; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D016121:Brachiocephalic Veins / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008026:Ligation; D017534:Radial Artery / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012086:Reoperation