지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2008.5
- 수록면
- 371 - 377 (7page)
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초록· 키워드
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Purpose: The hand ischemia that’s related to the construction of a vascular access is a serious and occasionally devastating complication. The traditional options for treating ischemic steal syndrome related to a functioning dialysis access graft or fistula include banding or ligation. Yet these procedures are directed toward increasing the resistance in the fistula, and they have yielded unreliable results. The technique of distal revascularization interval ligation provides satisfactory results in terms of healing of lesions, relief of symptoms and maintaining the vascular access. We report here on our experience with the DRIL procedure for relieving hand ischemia and maintaining the access patency in the setting of hemodialysis access-induced ischemia.
Methods: We performed a retrospective review of all patients who underwent the DRIL procedure for treating access-induced ischemia. The physicians’ office charts and hospital records were reviewed to determine the demographic data, the time to development of symptoms, the access and bypass patency, limb salvage and patient survival.
Results: From January 2001 and August 2005, the DRIL technique was used to treat 13 patients (8 women and 5 men: mean age: 59.6 years, 9 diabetic patients) who had functioning extremity fistulae and they presented with critical ischemia and steal syndrome. 9 patients had chronic ischemia, and acute ischemia developed in 4 patients. The fistulae were located at the elbow in 13 patients (4 brachiocephalic AVFs, 9 upperarm bridge grafts). The conduit used for the DRIL arterial bypasses (13 brachiobrachial bypasses) was the great sahpenous vein graft in 12 patients and an artificial graft was used in 1 patient. 2 patients had thrombotic occlusion in their arterial bypass. Open thrombectomy was used to treat all the patients. Limb salvage and maintenance of a functional fistula were achieved in 100% of the patients.
Conclusion: The DRIL procedure is the effective, suitable treatment for relieving hand ischemia without sacrificing the fistula. We recommend the DRIL procedure to all access surgeons as the good choice for dealing with the complex problems of steal syndrome, which is induced by a functioning AV access.
Methods: We performed a retrospective review of all patients who underwent the DRIL procedure for treating access-induced ischemia. The physicians’ office charts and hospital records were reviewed to determine the demographic data, the time to development of symptoms, the access and bypass patency, limb salvage and patient survival.
Results: From January 2001 and August 2005, the DRIL technique was used to treat 13 patients (8 women and 5 men: mean age: 59.6 years, 9 diabetic patients) who had functioning extremity fistulae and they presented with critical ischemia and steal syndrome. 9 patients had chronic ischemia, and acute ischemia developed in 4 patients. The fistulae were located at the elbow in 13 patients (4 brachiocephalic AVFs, 9 upperarm bridge grafts). The conduit used for the DRIL arterial bypasses (13 brachiobrachial bypasses) was the great sahpenous vein graft in 12 patients and an artificial graft was used in 1 patient. 2 patients had thrombotic occlusion in their arterial bypass. Open thrombectomy was used to treat all the patients. Limb salvage and maintenance of a functional fistula were achieved in 100% of the patients.
Conclusion: The DRIL procedure is the effective, suitable treatment for relieving hand ischemia without sacrificing the fistula. We recommend the DRIL procedure to all access surgeons as the good choice for dealing with the complex problems of steal syndrome, which is induced by a functioning AV access.
목차
서론
방법
결과
고찰
REFERENCES
참고문헌 (30)
참고문헌 신청
1. [단행본] - Wilson SE / 1996 / Complications of vascular access procedures: thrombosis, venous hypertension, arterial steal, and neuropathy. In: Wilson SE, editor. Vascular Access- Principles and Practices. 3nd ed / Mosby : 219 ~ 220
2. [학술지(정기간행물)] - Ballard JL / 1992 / Major complications of angioaccess surgery / Am J Surg 164 : 229 ~ 232
3. [학술지(정기간행물)] - DeCaprio JD / 1997 / Steal syndrome complicating hemodialysis access / Cardiovasc Surg 5 : 648 ~ 653
4. [학술지(정기간행물)] - Morsy AH / 1998 / Incidence and characteristics of patients with hand ischemia after a hemodialysis access procedure / J Surg Res 74 : 8 ~ 10
5. [학술지(정기간행물)] - Rosenthal JJ / 1980 / Prevention of high flow problems of arteriovenous grafts. Development of a new tapered graft / Am J Surg 140 : 231 ~ 233
2. [학술지(정기간행물)] - Ballard JL / 1992 / Major complications of angioaccess surgery / Am J Surg 164 : 229 ~ 232
3. [학술지(정기간행물)] - DeCaprio JD / 1997 / Steal syndrome complicating hemodialysis access / Cardiovasc Surg 5 : 648 ~ 653
4. [학술지(정기간행물)] - Morsy AH / 1998 / Incidence and characteristics of patients with hand ischemia after a hemodialysis access procedure / J Surg Res 74 : 8 ~ 10
5. [학술지(정기간행물)] - Rosenthal JJ / 1980 / Prevention of high flow problems of arteriovenous grafts. Development of a new tapered graft / Am J Surg 140 : 231 ~ 233
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UCI(KEPA) : I410-ECN-0101-2013-514-002693212