• Seminars in dialysis · Nov 2015

    Interrupting Rivaling Access-flow with Nonsurgical Image-guided ligation: the "IRANI" Procedure.

    • Jie Cui, Robert Freed, Fengyong Liu, and Zubin Irani.
    • Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
    • Semin Dial. 2015 Nov 1; 28 (6): E53-7.

    AbstractThe presence of collateral veins is one of the most common causes of fistula failure to mature. The traditional approach to eliminate collateral vessel flow is coil embolization under fluoroscopy or surgical cut down and branch vessel ligation. However, both approaches are expensive and time consuming. Here, we described an image-guided nonsurgical method to ligate collateral veins. The collateral veins were ligated using Hawkins-Akins needle under ultrasound guidance. The average time for one ligation procedure was 17 minutes. There was a significant increase of blood flow in the venous outflow postligation procedure. Four weeks postprocedure ultrasound demonstrated occlusion of the target vessels. This procedure was well tolerated without major complications. In summary, the novel procedure described here offers an image-guided nonsurgical approach for collateral vein occlusion.© 2015 Wiley Periodicals, Inc.

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