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< Vol. 16 Suppl. 9 - Presentations of the European Vascular Access Course 2015

Intervention for access-induced ischemia: which option is the best?

Intervention for access-induced ischemia: which option is the best?

J Vasc Access 2015; 16(Suppl. 9): 102 - 107

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jva.5000338

Authors

Florian Thermann

Corresponding author

  • Florian Thermann
  • Department of Vascular Surgery
  • Weiße Mauer 52
  • 06217 Merseburg, Germany
  • f.thermann@klinikum-saalekreis.de

Abstract

Access-induced ischemia is a rare but important surgical complication with potentially devastating long-term results. The question remains which therapeutic option is the best for the different forms of ischemia.

A review of the literature concerning access-induced ischemia (classification, treatment) was performed; furthermore, our own experience of more than 300 cases with ischemia was discussed.

There are four different stages of dialysis access-induced ischemia syndrome (DAIIS) that need adequate treatment: stage I conservatively, stage II fistula banding, stage III proximalization operation or distal revascularization interval ligation and stage IV closure of the access.

According to the many publications and to our own experience, there are good therapeutic options for many of the patients with DAIIS. However, in case of extended lesions/gangrene, closure of the access should be discussed in time before major amputation becomes necessary.

Article History

  • • Accepted on 23/11/2014
  • • Available online on 08/03/2015
  • • Published in print on 09/03/2015

Disclosures

Financial support: None.
Conflict of interest: None declared.

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Authors

  • Thermann, Florian [PubMed] [Google Scholar] , * Corresponding Author (f.thermann@klinikum-saalekreis.de)

Affiliations

  • Department of Vascular Surgery, University teaching Hospital Carl von Basedow Merseburg, Merseburg - Germany

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