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Distal Revascularization And Interval Ligation
Distal Revascularization and Interval Ligation (DRIL) is a surgical method of treating vascular access steal syndrome. __TOC__ History DRIL was first proposed by Harry Schanzer and colleagues in 1988. Procedure A short distal bypass is created and the artery just distal to the AV anastomosis An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf#Veins, leaf veins, or streams. Such a connection m ... is ligated. References Nephrology Vascular surgery {{Surgery-stub ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually span ...
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Vascular Access Steal Syndrome
In nephrology, vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis. Signs * Pallor * Diminished pulses (distal to the fistula) * Necrosis * Decreased wrist-brachial artery, brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm), especially if below 0.6 Symptoms * Pain and nociception, Pain distal to the fistula. Symptoms are graded by their severity: * Grade 0: No symptoms of steal * Grade 1: Mild - cool extremity, improvement in hand pulse with access occlusion * Grade 2: Moderate - Ischemic symptoms during dialysis * Grade 3: Severe - Ischemic hand pain outside of dialysis; Ulcers or gangrene of the fingers Diagnosis * History and physical exam - relief of symptoms with compression ...
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Anastomosis
An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be normal (such as the foramen ovale in a fetus's heart) or abnormal (such as the patent foramen ovale in an adult's heart); it may be acquired (such as an arteriovenous fistula) or innate (such as the arteriovenous shunt of a metarteriole); and it may be natural (such as the aforementioned examples) or artificial (such as a surgical anastomosis). The reestablishment of an anastomosis that had become blocked is called a reanastomosis. Anastomoses that are abnormal, whether congenital or acquired, are often called fistulas. The term is used in medicine, biology, mycology, geology, and geography. Etymology Anastomosis: medical or Modern Latin, from Greek ἀναστόμωσις, anastomosis, "outlet, opening", Gr ana- "up, on, upon", stoma "mouth", ...
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Nephrology
Nephrology (from Greek'' nephros'' "kidney", combined with the suffix ''-logy'', "the study of") is a specialty of adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function (renal physiology) and kidney disease (renal pathophysiology), the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy (dialysis and kidney transplantation). The word “ renal” is an adjective meaning “relating to the kidneys”, and its roots are French or late Latin. Whereas according to some opinions, "renal" and "nephro" should be replaced with "kidney" in scientific writings such as "kidney medicine" (instead of nephrology) or "kidney replacement therapy", other experts have advocated preserving the use of renal and nephro as appropriate including in "nephrology" and "renal replacement therapy", respectively. Nephrology also studies systemic conditions that ...
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