One-year efficacy of the RUDI technique for flow reduction in high-flow autologous brachial artery-based hemodialysis vascular access
J Vasc Access 2015; 16(Suppl. 9): 96 - 101
Article Type: ORIGINAL ARTICLE
DOI:10.5301/jva.5000357
Authors
Roel H.D. Vaes, Magda van Loon, Selma M.M. Vaes, Philippe Cuypers, Jan H. Tordoir, Marc R. Scheltinga
Corresponding author
- Roel H.D. Vaes
- Department of Surgery
- de Run 4600
- 5500 MB Veldhoven, The Netherlands
- r.vaes@mmc.nl
Abstract
Flow reduction is advised in hemodialysis (HD) patients with a high-flow (>2 L/min) arteriovenous fistula (AVF). The revision using distal inflow (RUDI) technique is based on the premise that access flow is attenuated once inflow is provided by a smaller caliber forearm artery. Aim of the study was to evaluate the efficacy of RUDI during a 1-year follow-up.
All HD patients undergoing a RUDI operation using a greater saphenous vein (GSV) or a basilic vein (BaV) interposition for a high-flow access (HFA, >2 L/min) during a 3.5-year time period were included. Serial access flow, percentage of freedom from recurrent high flow and complications were determined.
A total of 19 HFA patients were studied (11 males, age 55 ± 3 years). All AVFs were brachial artery based (brachiocephalic, n = 14; brachiobasilic, n = 5). RUDI immediately reduced access flow by almost 2 L/min (3,080 ± 200 to 1,170 ± 160 mL/min (p = 0.001)). Access flows at 1, 6 and 12 months were 1,150 ± 160, 1,460 ± 200 and 1,580 ± 260 mL/min, respectively. Postoperative complications included insufficient flow reduction (n = 1, BaV) and occlusion requiring revision (n = 1, GSV). Recurrent HFA occurred three times (n = 2 BaV, n = 1 GSV). Access flows were significantly (p<0.05) higher in the BaV group compared to the GSV group.
RUDI effectively reduces access flow in a brachial artery-based high-flow HD vascular access. A flow-reducing effect is sustained at 1-year follow-up in most patients. GSV is preferred as an interposition graft compared to a BaV.
Article History
- • Accepted on 19/12/2014
- • Available online on 08/03/2015
- • Published in print on 09/03/2015
Disclosures
This article is available as full text PDF.
Authors
- Vaes, Roel H.D. [PubMed] [Google Scholar] 1, * Corresponding Author (r.vaes@mmc.nl)
- van Loon, Magda [PubMed] [Google Scholar] 2
- Vaes, Selma M.M. [PubMed] [Google Scholar] 3
- Cuypers, Philippe [PubMed] [Google Scholar] 4
- Tordoir, Jan H. [PubMed] [Google Scholar] 2, 5
- Scheltinga, Marc R. [PubMed] [Google Scholar] 1, 5
Affiliations
- Department of Surgery, Máxima Medical Center, Veldhoven - The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht - The Netherlands
- Maastricht University, Maastricht - The Netherlands
- Department of Surgery, Catharina Hospital, Eindhoven - The Netherlands
- Carim Research School, Maastricht University Medical Center, Maastricht - The Netherlands
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