A mechanism of banding failure in excessively dilated fistulas.

CONCLUSIONS: Identical findings in these four patients suggest that the extensive infolding and caliber diameter reduction created by banding these massively dilated fistulas, when combined with the pulsatility induced in the pre-banding segment, leads to a gradual incorporation of the suture tie into the vessel wall and finally within the lumen. We suggest erosion of banding material and failure of flow reduction may occur with any technique but may be more likely with a single polypropylene suture restricting very large AVF. We suggest such excessively dilated fistulas requiring flow reduction may be successfully treated by reconstruction of the AVF anastomosis to a much smaller size with tapering of the outflow vein to accommodate the revision.
PMID: 28777410 [PubMed - as supplied by publisher]

Source: The Journal of Vascular Access - August 6, 2017 Category: Surgery Tags: J Vasc Access Source Type: research