TY - JOUR
T1 - Minimally invasive limited ligation endoluminal-assisted revision (MILLER)
T2 - A review of the available literature and brief overview of alternate therapies in dialysis associated steal syndrome
AU - Sheaffer, William W.
AU - Hangge, Patrick T.
AU - Chau, Anthony H.
AU - Alzubaidi, Sadeer J.
AU - Knuttinen, M. Grace
AU - Naidu, Sailendra G.
AU - Ganguli, Suvranu
AU - Oklu, Rahmi
AU - Davila, Victor J.
N1 - Publisher Copyright:
© 2018 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2018/6
Y1 - 2018/6
N2 - Dialysis associated steal syndrome (DASS) is a relatively rare but debilitating complication of arteriovenous fistulas. While mild symptoms can be observed, if severe symptoms are left untreated, DASS can result in ulcerations and limb threatening ischemia. High-flow with resultant heart failure is another documented complication following dialysis access procedures. Historically, open surgical procedures have been the mainstay of therapy for both DASS as well as high-flow. These procedures included ligation, open surgical banding, distal revascularization-interval ligation, revascularization using distal inflow, and proximal invasion of arterial inflow. While effective, open surgical procedures and general anesthesia are preferably avoided in this high-risk population. Minimally invasive limited ligation endoluminal-assisted revision (MILLER) offers both a precise as well as a minimally invasive approach to treating both dialysis associated steal syndrome as well as high-flow with resultant heart failure. MILLER is not ideal for all DASS patients, particularly those with low-flow fistulas. We aim to briefly describe the open surgical therapies as well as review both the technical aspects of the MILLER procedure and the available literature.
AB - Dialysis associated steal syndrome (DASS) is a relatively rare but debilitating complication of arteriovenous fistulas. While mild symptoms can be observed, if severe symptoms are left untreated, DASS can result in ulcerations and limb threatening ischemia. High-flow with resultant heart failure is another documented complication following dialysis access procedures. Historically, open surgical procedures have been the mainstay of therapy for both DASS as well as high-flow. These procedures included ligation, open surgical banding, distal revascularization-interval ligation, revascularization using distal inflow, and proximal invasion of arterial inflow. While effective, open surgical procedures and general anesthesia are preferably avoided in this high-risk population. Minimally invasive limited ligation endoluminal-assisted revision (MILLER) offers both a precise as well as a minimally invasive approach to treating both dialysis associated steal syndrome as well as high-flow with resultant heart failure. MILLER is not ideal for all DASS patients, particularly those with low-flow fistulas. We aim to briefly describe the open surgical therapies as well as review both the technical aspects of the MILLER procedure and the available literature.
KW - Arteriovenous fistula
KW - Arteriovenous fistula banding
KW - Dialysis associated steal syndrome
KW - High flow
KW - MILLER
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U2 - 10.3390/jcm7060128
DO - 10.3390/jcm7060128
M3 - Review article
AN - SCOPUS:85111119707
SN - 2077-0383
VL - 7
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 6
M1 - 128
ER -