Introduction: Non-maturing arteriovenous fistula is a common problem in hemodialysis units. The main reasons for maturation failure include a poor venous system, vein stenosis, stenosis in an anastomosis, or the presence of collateral veins. Currently, the usual approach to eliminate collateral vein drainage consists in surgical ligation or coil embolization; however, these procedures are time-consuming, logistically demanding and expensive. Alternatively, various types of percutaneous ligation are done. Below follows the description of a technique of image-guided percutaneous ligation of collateral veins and an analysis of our cohort of patients.
Method: A retrospective study of prospectively enrolled patients with non-maturing arteriovenous fistulae. The criterion of success was defined as successful hemodialysis within 4 weeks after percutaneous ligation.
Results: During a 2-year period (March 2015 - January 2017) 7 patients underwent 11 ligations of collateral veins. In all patients the arteriovenous shunts matured successfully for hemodialysis within 2 or 3 weeks following the ligation.
Conclusion: The novel technique is fast, inexpensive and provides a good clinical and cosmetic outcome.Key words: arteriovenous fistula - collateral veins - percutaneus ligation.