Minimally invasive banding procedure

Abstract

The creation of a hemodialysis access is a non-physiological process that joins the high flow arterial circuit to the low-flow, low-resistance venous pathway. This creates the potential for a spectrum of problems, including high-output cardiac failure and vascular access-associated distal hypoperfusion ischemic syndrome (DHIS) or steal syndrome. High-output cardiac failure occurs when the cardiac function is unable to meet up with the demands created by the shunting effects of the AV access while DHIS results when the AV access diverts an excessive amount of blood away from the distal artery, resulting in tissue hypoperfusion. Banding of the AV access is a procedure that is used to reduce the blood flow to the access by creating a high resistance band to restrict the flow of blood into the AV access. Specifically, the MILLER (Minimally Invasive Limited Ligation Endoluminal-Assisted Revision) banding procedure is a technique that can be used to reduce blood flow to the access with the aid of fluoroscopy and endovascular equipments.