scholarly journals Volume Flow Measurements in Arteriovenous Dialysis Access in Patients with and without Steal Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Charudatta S. Bavare ◽  
Jean Bismuth ◽  
Hosam F. El-Sayed ◽  
Tam T. Huynh ◽  
Eric K. Peden ◽  
...  
Keyword(s):  
Volume Flow ◽  
Dialysis Access ◽  
Flow Measurements ◽  
Steal Syndrome

Analysis of Factors Influencing Accuracy of Volume Flow Measurement in Dialysis Access Fistulas Based on Duplex Ultrasound Simulation

2019 ◽  
Vol 53 (7) ◽  
pp. 529-535 ◽  
Author(s):  
R. Eugene Zierler ◽  
Daniel F. Leotta ◽  
Kurt Sansom ◽  
Alberto Aliseda ◽  
Mark D. Anderson ◽  
...  
Keyword(s):  
Flow Measurement ◽  
Duplex Ultrasound ◽  
Volume Flow ◽  
Cross Sectional Area ◽  
Surface Model ◽  
Dialysis Access ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flow Measurements ◽  
Measuring Volume

Objective:We developed a duplex ultrasound simulator and used it to assess accuracy of volume flow measurements in dialysis access fistula (DAF) models.Methods:The simulator consists of a mannequin, computer, and mock transducer. Each case is built from a patient’s B-mode images that are used to create a 3-dimensional surface model of the DAF. Computational fluid dynamics is used to determine blood flow velocities based on model vessel geometry. The simulator displays real-time B-mode and color-flow images, and Doppler spectral waveforms are generated according to user-defined settings. Accuracy was assessed by scanning each case and measuring volume flow in the inflow artery and outflow vein for comparison with true volume flow values.Results:Four examiners made 96 volume flow measurements on four DAF models. Measured volume flow deviated from the true value by 35 ± 36%. Mean absolute deviation from true volume flow was lower for arteries than veins (22 ± 19%, N = 48 vs. 58 ± 33%, N = 48, p < 0.0001). This finding is attributed to eccentricity of outflow veins which resulted in underestimating true cross-sectional area. Regression analysis indicated that error in measuring cross-sectional area was a predictor of error in volume flow measurement (β = 0.948, p < 0.001). Volume flow error was reduced from 35 ± 36% to 9 ± 8% ( p < 0.000001) by calculating vessel area as an ellipse.Conclusions:Duplex volume flow measurements are based on a circular vessel shape. DAF inflow arteries are circular, but outflow veins can be elliptical. Simulation-based analysis showed that error in measuring volume flow is mainly due to assumption of a circular vessel.

Chronic Ischemic Monomelic Neuropathy after Arteriovenous Fistula Creation: A Unique Presentation of Vascular Steal

2020 ◽  
Vol 3 (2) ◽  
pp. 147-150
Author(s):  
Kaczynski RE ◽  
Asaad Y ◽  
Valentin-Capeles N ◽  
Battista J
Keyword(s):  
Arteriovenous Fistula ◽  
Complete Loss ◽  
Dialysis Access ◽  
Loss Of Function ◽  
Access Site ◽  
Surgical Ligation ◽  
Arteriovenous Access ◽  
Vascular Steal ◽  
Steal Syndrome

We discuss a case of a 58 year old male who presented for left upper extremity steal syndrome including ischemic monomelic neuropathy (IMN) 1.5 months after arteriovenous fistula creation. He presented after three surgical attempts to salvage his fistula with rest pain, complete loss of function with contracture of the 4th and 5th digits, and loss of sensation in the ulnar distribution for more than three weeks. At our institution, he underwent surgical ligation of the distal fistula and creation of a new fistula proximally, resulting in complete resolution of his vascular steal symptoms almost immediately despite the chronicity prior to surgical presentation. Our patient provides a unique perspective regarding dialysis access salvage versus patient quality of life. The patients’ functional status and pain levels should take precedence over salvage of an arteriovenous access site, and early ligation of the access should be completed prior to chronic IMN development. However, if a patient presents late along the IMN course, we recommend strong consideration of access ligation in order to attempt to regain the full neurovascular function of the extremity as we experienced in our patient.

Volume Flow Measurements

1975 ◽  
pp. 293-298
Author(s):  
Arnošt Kotyk ◽  
Karel Janáček
Keyword(s):  
Volume Flow ◽  
Flow Measurements

Lateral Velocity Profile and Volume Flow Measurements Via 2-D Speckle Tracking

1995 ◽  
pp. 503-507 ◽  
Author(s):  
L. N. Bohs ◽  
B. H. Friemel ◽  
B. A. McDermott ◽  
G. E. Trahey
Keyword(s):  
Velocity Profile ◽  
Speckle Tracking ◽  
Volume Flow ◽  
Lateral Velocity ◽  
Flow Measurements

scholarly journals Distal Radial Artery Ligation for Dialysis Access Steal Syndrome

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
David Fung ◽  
Yaasin Abdulrehman
Keyword(s):  
Radial Artery ◽  
Surgical Techniques ◽  
Limb Ischemia ◽  
Definitive Treatment ◽  
Dialysis Access ◽  
Artery Ligation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Steal Syndrome ◽  
Distal Radial Artery

Renal replacement therapy is the definitive treatment for end stage renal disease apart from transplant. Steal syndrome, which can lead to distal limb ischemia, is a rare but serious complication in patients who undergo hemodialysis with an arteriovenous fistula. We present a case of a 48-year-old female with limited options for dialysis access who presented with symptoms of steal syndrome. Given the need to keep her current fistula, we opted to treat her with distal radial artery ligation. This case report summarizes the various surgical techniques available for treating dialysis access-associated steal syndrome and why distal radial artery ligation should be considered a viable management strategy, especially in the context of our patient.

scholarly journals P05.02: Volume flow measurements in normal pregnancies and fetal growth restriction

2004 ◽  
Vol 24 (3) ◽  
pp. 296-296
Author(s):  
J. Leonce ◽  
N. Venkat-Raman ◽  
W. T. S. Lo ◽  
S. Robinson ◽  
K. Murphy ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Volume Flow ◽  
Growth Restriction ◽  
Flow Measurements

MILLER Banding Procedure for Treatment of Dialysis Access–Related Steal Syndrome, Pulmonary Hypertension, and Heart Failure

2021 ◽  
pp. 000313482110562
Author(s):  
Ahmad Alqassieh ◽  
Patrick B. Dennis ◽  
Veena Mehta ◽  
June Shi ◽  
Angello Lin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Vascular Access ◽  
Primary Patency ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Long Term Follow Up ◽  
Steal Syndrome

A Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) banding procedure has been used for treating patients with dialysis access–related steal syndrome (DASS) and high-flow vascular access–related pulmonary hypertension (PHT) and heart failure (HF). We performed a retrospective analysis of patients undergoing the MILLER procedure performed for DASS, HF, and PHT from our Vascular Access Database from September 2017 to October 2019. Outcomes included primary patency of banding, primary assisted patency, and secondary patency, using time-to-event analyses with Kaplan-Meier curves and life tables to estimate 6- and 12-month rates. A total of 13 patients (6 men and 7 women, mean age 60 ± 14 years) underwent the MILLER procedure, 6 patients for DASS and 7 patients for pulmonary hypertension and heart failure (PHT/HF). Technical success was achieved in all patients. The longest duration of follow-up was 28 months (median 12 months [IQR 7, 19]). One patient died at 1 month after the intervention due to stroke. One patient developed access thrombosis of the graft 3 days after the procedure. Repeat banding was required in 1 patient 8 months after the first procedure. The 6-month primary patency rate of banding following this procedure was 83% while the 12-month rate was 66%. The 6- and 12-month secondary patency rates were 87% and 75%, respectively. The MILLER procedure can be performed for DASS and PHT/HF with improvement of symptoms and good long-term patency rates. Additional interventions to maintain patency and efficacy are required on long-term follow-up.

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