title: Surgical banding for refractory hemodialysis access-induced distal ischemia (HAIDI).
abstract: Hemodialysis patients may develop distal ischemia in an extremity harboring a functioning arteriovenous access (AVA). Surgery is indicated if conservative treatment including catheter-based therapies fails. The role of surgical banding for refractory hemodialysis access-induced distal ischemia (HAIDI) is systematically reviewed (n=39 articles). If banding is executed without an intraoperative monitoring tool ("blind"), or guided by finger pressures only, clinical success and access patency rates are low (<50%). In contrast, banding is clinically successful when access flow is monitored during the operative procedure, with excellent long-term patency of banded AVA's (97%, 17 +/- 3 months). Banding is the method of choice in HAIDI patients with a normal or high access flow (>1.2 l/min) provided that flow and distal perfusion are closely monitored intraoperatively.
authors.affiliation: Department of Surgery, Maxima Medical Center, Veldhoven - The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: Scheltinga
authors.forename: F
authors.initials: F
authors.lastname: Van Hoek
authors.forename: C M A
authors.initials: CM
authors.lastname: Bruyninckx