Claus G. Schneider, MD, Karim A

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Presentation transcript:

T-banding: A technique for flow reduction of a hyperfunctioning arteriovenous fistula Claus G. Schneider, MD, Karim A. Gawad, MD, Tim Strate, MD, Benjamin Pfalzer, MD, Jakob R. Izbicki, MD Journal of Vascular Surgery Volume 43, Issue 2, Pages 402-405 (February 2006) DOI: 10.1016/j.jvs.2005.11.047 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 Preparation of the patch for T-banding. A, A 60-mm-long, 8-mm thin-wall expanded polytetrafluoroethylene graft segment is cut open longitudinally to form a 60-mm × 24-mm patch. B, After measuring the diameter of the arterial inflow and arterial outflow the circumferences α and β were calculated, with 3 as an estimation for π. Half of venous outflow circumference δ was set to 9 mm by experience (resulting in a 6-mm diameter). Distances α, β and δ were marked (little crosses) on the patch. C, Dotted lines were drawn on the patch to determine the shape of the T-band. D, After cutting along the dotted lines, the shape of the T-band is demonstrated. E, Once folded, the T-band is ready for implantation. Journal of Vascular Surgery 2006 43, 402-405DOI: (10.1016/j.jvs.2005.11.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 The enlarged anastomosis and dilated shunt vein before (A) and after T-banding (B). Journal of Vascular Surgery 2006 43, 402-405DOI: (10.1016/j.jvs.2005.11.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 T-band in situ covering the anastomosis of an upper arm fistula. Journal of Vascular Surgery 2006 43, 402-405DOI: (10.1016/j.jvs.2005.11.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 Cross-section of the wrapped shunt vein within the patch early after operation (A) and 1.5 years later (B). Journal of Vascular Surgery 2006 43, 402-405DOI: (10.1016/j.jvs.2005.11.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions