title: Augmented balloon-assisted maturation (aBAM) for nonmaturing dialysis arteriovenous fistula.
abstract: OBJECTIVE
  The surgically placed dialysis arteriovenous fistula (AVF) is considered by the Kidney Disease Outcomes Quality Initiative (KDOQI)and the Fistula First Breakthrough Initiative to be the ideal choice for hemodialysis access. A significant number of newly placed AVFs either slowly or never adequately mature sufficiently to provide for adequate dialysis. The balloon-assisted maturation (BAM) procedure utilizes serial angioplasty to promote and accelerate AVF maturation. We present a minimally invasive AVF maturation technique utilizing angioplasty, stent-graft, and coil embolization.
  
  
  METHODS
  A 41-year-old white woman presented with an nonmaturing AVF with multiple venous outflow channels. An adequately functioning AVF was achieved after 2 treatments including coil embolization, angioplasty, and stent-graft placement.
  
  
  RESULTS
  Adequate thrill and dialysis flow was achieved. Patient has done well during short-term follow-up without further intervention.
  
  
  CONCLUSIONS
  BAM techniques can be an effective tool to help a dialysis patient achieve an adequately mature AVF. Additional vascular interventional techniques may be utilized to further improve clinical results. For the purpose of this report we call this technique "augmented balloon-assisted maturation," or aBAM.
authors.affiliation: Midwest Institute for Minimally Invasive Therapies, Melrose Park, Illinois, USA. invasivedoc@yahoo.com
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Samett
authors.forename: Joshua
authors.initials: J
authors.lastname: Hastie
authors.forename: Paramjit Romi
authors.initials: PR
authors.lastname: Chopra
authors.forename: Sujit
authors.initials: S
authors.lastname: Pradhan
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Ahmad
authors.forename: Terence
authors.initials: T
authors.lastname: Chiramel
authors.forename: Reginald
authors.initials: R
authors.lastname: Joseph
mesh_terms: D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D004621:Embolization, Therapeutic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis; D015607:Stents; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency