Sharp needle recanalization for salvaging hemodialysis accesses with chronically occluded peripheral outflow.

Purpose: To assess the effectiveness of sharp needle recanalization (SNR) for treatment of chronically occluded venous outflow in hemodialysis access.

Methods: A retrospective analysis of patient records from January 2006 to March 2010 was conducted. Forty-four hemodialysis patients (31 fistulas, 13 grafts) were referred for arm swelling (18%), excessive bleeding after dialysis (29%), and thrombosis (53%).

Percutaneous salvage of thrombosed immature arteriovenous fistulas.

Thrombosed immature fistulas have historically been considered unsalvageable. However, advances in procedure and balloon catheter technologies have expanded the scope of endovascular treatments. This study investigates the efficacy, functionality, and cost associated with the use of percutaneous techniques for the salvage of thrombosed immature fistulas.

Access flow reduction and recurrent symptomatic cephalic arch stenosis in brachiocephalic hemodialysis arteriovenous fistulas.

Background: Recurrent cephalic arch stenosis (CAS) has been linked to high flow and has a high rate of recurrence following angioplasty. This study investigates the effectiveness of access flow reduction in decreasing rapidly recurrent symptomatic CAS.

Methods: A retrospective study of patient records from February 2005 to April 2009 was conducted.

Long thoracic vein embolization for the treatment of breast edema associated with central venous occlusion and venous hypertension.

Purpose: Breast edema is a rare complication in hemodialysis patients with central venous occlusions. The present study sought to determine whether coil embolization of the long thoracic vein is an effective long-term treatment for this pathology.

Methods: The study patients were 6 female hemodialysis patients whose primary clinical manifestation of central vein occlusion was breast edema.

The MILLER banding procedure is an effective method for treating dialysis-associated steal syndrome.

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.

Aggressive approach to salvage non-maturing arteriovenous fistulae: a retrospective study with follow-up.

Purpose: To establish a standardized approach for the maturation of non-maturing arteriovenous fistulae.

Methods: Consecutive patients (n=122) with non-maturing fistulae presented to our outpatient vascular access center for percutaneous interventions to assist in maturation. The techniques used included flow rerouting, competing branch vein elimination, staged balloon angioplasty, and limited controlled extravasation.