{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:17:51Z","timestamp":1778156271603,"version":"3.51.4"},"reference-count":11,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Percutaneous arteriovenous fistulas (pAVFs) are an important technological advancement in dialysis access but often suffer from incomplete maturation and poor cannulation due to split flow. The Real-time Angio Zonal Diversion via Acoustic Navigation (RAZDAN) technique is a minimally invasive, ultrasound-guided ligation method to redirect blood flow and improve cannulation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective, multicenter, multispecialty study evaluated 154 patients with immature Ellipsys pAVF using the RAZDAN technique between 2019 and 2024 to assist with maturation and subsequent cannulation. Outcomes included technical success, infection rate, and sustained occlusion at 6\u2009months. Time intervals from access creation to maturation and catheter removal were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Using the RAZDAN technique, 100% technical success was achieved without hospital-requiring complications. Mean time from access creation to maturation was 49.5\u2009days, and to catheter removal was 95.5\u2009days. Following ligation, maturation occurred at an average of 15.0\u2009days, and catheter removal in 58.0\u2009days. Infection occurred in 1.9% and nerve-related discomfort in 1.2%, all treated or resolved without hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The RAZDAN technique offers a safe, effective, and reproducible option for enhancing cannulation in pAVFs. It provides a minimally invasive alternative for non-surgical specialists, potentially shortening catheter dependence and improving vascular access outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298251375173","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T09:51:57Z","timestamp":1762163517000},"page":"1310-1318","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-time angio zonal diversion via acoustic navigation: A retrospective evaluation of 154 patients using a novel ligation technique to divert flow and maximize cannulation success in pAVF"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2459-399X","authenticated-orcid":false,"given":"Rishi","family":"Razdan","sequence":"first","affiliation":[{"name":"Azura Vascular Care of Jacksonville, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashid","family":"Sharaf","sequence":"additional","affiliation":[{"name":"Star Vascular Care, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Torgbenu","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care, Bryn Mawr, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Razdan","sequence":"additional","affiliation":[{"name":"Advanced Medical Imaging, Lincoln, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari","family":"Kramer","sequence":"additional","affiliation":[{"name":"Spartanburg Regional Medical Center, Spartanburg, SC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodi","family":"Gray","sequence":"additional","affiliation":[{"name":"Azura Vascular Care of Jacksonville, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balkees","family":"Chalabi","sequence":"additional","affiliation":[{"name":"Azura Vascular Care of Jacksonville, Jacksonville, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemma","family":"Reinhardt","sequence":"additional","affiliation":[{"name":"Star Vascular Care, San Antonio, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Sor","sequence":"additional","affiliation":[{"name":"HealthQare Services, Arlington, VA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.02.033"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.22730\/jmls.2023.20.4.178"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.4527"},{"issue":"8","key":"e_1_3_2_5_2","article-title":"Optimal hemodialysis arteriovenous fistula flow volume for cardiovascular safety","volume":"17","author":"Elfekky EM","year":"2020","unstructured":"Elfekky EM, Lotfy AA, Diab OA, et al. Optimal hemodialysis arteriovenous fistula flow volume for cardiovascular safety. Vasc Dis Manag 2020; 17(8): E170\u2013E177.","journal-title":"Vasc Dis Manag"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.02.048"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.02.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241272166"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12450"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.461"},{"issue":"1","key":"e_1_3_2_11_2","first-page":"1","article-title":"Prophylactic ligation of the median antecubital vein to improve the patency of a radio cephalic fistula","volume":"4","author":"Chevuturu C","year":"2016","unstructured":"Chevuturu C, Somasekhar M, Maitra S, et al. Prophylactic ligation of the median antecubital vein to improve the patency of a radio cephalic fistula. Adv Surg Sci 2016; 4(1): 1\u20135.","journal-title":"Adv Surg Sci"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.01.024"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251375173","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298251375173","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251375173","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T12:00:55Z","timestamp":1778155255000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298251375173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,3]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/11297298251375173"],"URL":"https:\/\/doi.org\/10.1177\/11297298251375173","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,3]]}}}