Dril operation

DRIL stands for the acronym: "distal revascularization interval ligation". DRIL surgery is a surgical method of shunt surgery.

In dialysis steal syndrome, too much blood flows through the artificially created dialysis shunt through the shunt bypass. This can lead to circulatory problems in the hand. If the shunt volume is too large, necrosis of the fingers may occur.

During DRIL surgery, the retrograde inflow into the fistula is prevented. This is done by ligating the brachial artery directly behind the shunt. In addition, a bypass is made from the brachial artery above the shunt to the brachial artery behind the ligature using a vascular prosthesis.

1. Al Shakarchi J et al (2016) Surgical techniques for haemodialysis access-induced distal ischaemia. J Vasc Access 17: 40-46.
2. Bracale UM et al (2015) Management of finger gangrene caused by steal syndrome in vascular access for hemodialysis Personal experience and a brief review of the literature. Ann Ital Chir 86:239-245.
3. Vaes RH et al (2015) Venous Side Branch Ligation as a First Step Treatment for Haemodialysis Access Induced Hand Ischaemia: Effects on Access Flow Volume and Digital Perfusion. Eur J Vasc Endovasc Surg 50:810-814.