{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:06:54Z","timestamp":1784531214951,"version":"3.55.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"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":[[2026,7]]},"abstract":"<jats:p>Ischemic monomelic neuropathy (IMN) is a rare neurological complication following the creation of hemodialysis access and is believed to result from ischemic injury to distal nerve fibers due to shunting of limb blood flow, leading to acute pain, sensory loss, and weakness with potential functional limb loss. Symptoms are typically abrupt but may appear weeks to months after surgery. We conducted a systematic review in accordance with PRISMA 2020, searching MEDLINE (PubMed), EMBASE, CINAHL, Web of Science, and Google Scholar from inception to August 2025 for reports of IMN following arteriovenous access creation, including case reports, case series, and letters with extractable clinical data, with individual patient data extracted when available. Of 184 records identified, 36 studies met inclusion criteria, describing 60 patients, most of whom developed IMN in the upper limb after brachial artery\u2013based access. Diabetes mellitus was present in approximately 72% of cases, and clinical presentation most commonly occurred within hours to days of access creation with severe pain, sensory disturbances, and motor deficits. Early intervention, particularly prompt ligation of the arteriovenous access, was most consistently associated with neurological improvement. IMN remains an uncommon but serious complication following arteriovenous access creation, and available evidence is limited to case-based literature, precluding definitive management recommendations; however, early recognition and expeditious access ligation appear to provide the best chance for neurological recovery.<\/jats:p>","DOI":"10.1177\/11297298261424636","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T09:10:58Z","timestamp":1773220258000},"page":"1515-1519","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ischemic monomelic neuropathy following arteriovenous access creation: A systematic review"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3735-4841","authenticated-orcid":false,"given":"Ahmed","family":"Elmetwally","sequence":"first","affiliation":[{"name":"East Lancashire Hospital Trust, Royal Blackburn Hospital, Blackburn, UK"},{"name":"Faculty of Medicine, Mansoura University, Mansoura, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1399-5724","authenticated-orcid":false,"given":"Amr","family":"Meselhi","sequence":"additional","affiliation":[{"name":"East Lancashire Hospital Trust, Royal Blackburn Hospital, Blackburn, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem","family":"Elsanatawy","sequence":"additional","affiliation":[{"name":"East Lancashire Hospital Trust, Royal Blackburn Hospital, Blackburn, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Abdelhaliem","sequence":"additional","affiliation":[{"name":"East Lancashire Hospital Trust, Royal Blackburn Hospital, Blackburn, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham","family":"Al-Khaffaf","sequence":"additional","affiliation":[{"name":"East Lancashire Hospital Trust, Royal Blackburn Hospital, Blackburn, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.33.4.447"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02017415"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2016.08.013"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5301\/JVA.2011.6365"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.06.947"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2024.08.001"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(05)80007-3"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.11.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl722"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2020.12.022"},{"key":"e_1_3_3_12_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.","journal-title":"BMJ"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820913376"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.14740\/jmc4206"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.42.9.810"},{"key":"e_1_3_3_16_2","first-page":"113","article-title":"A case of ischemic monomelic neuropathy after arteriovenous fistula placement","volume":"13","author":"Sangani V","year":"2023","unstructured":"Sangani V, Pokal M, Noel E, et al. A case of ischemic monomelic neuropathy after arteriovenous fistula placement. J Community Hosp Intern Med Perspect 2023; 13: 113\u2013117.","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"e_1_3_3_17_2","first-page":"199","article-title":"Ischaemic monomelic neuropathy in a diabetic patient after brachio-basilic arteriovenous fistula creation","volume":"5","author":"Shannon NB","year":"2016","unstructured":"Shannon NB, Chng SP, Suai Tan C, et al. Ischaemic monomelic neuropathy in a diabetic patient after brachio-basilic arteriovenous fistula creation. Case Rep Clin Med 2016; 5: 199\u2013202.","journal-title":"Case Rep Clin Med"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.36502\/2020\/ASJBCCR.6203"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231160577"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.4236\/wjcs.2017.73004"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2017.78.5.292"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01523.x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000394"},{"issue":"7","key":"e_1_3_3_24_2","article-title":"Ischemic monomelic neuropathy after arteriovenous fistula surgery: clinical features, electrodiagnostic findings, and treatment","volume":"11","author":"Datta S","year":"2019","unstructured":"Datta S, Mahal S, Govindarajan R. Ischemic monomelic neuropathy after arteriovenous fistula surgery: clinical features, electrodiagnostic findings, and treatment. Cureus 2019; 11(7): e5191.","journal-title":"Cureus"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.4103\/cmi.cmi_39_22"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.12701\/jyms.2024.00948"},{"key":"e_1_3_3_27_2","first-page":"60","article-title":"Ischemic monomelic neuropathy: a complication of vascular access procedure","volume":"13","author":"Rabbani MA","year":"2002","unstructured":"Rabbani MA, Ahmad A, Shah SMA, et al. Ischemic monomelic neuropathy: a complication of vascular access procedure. Saudi J Kidney Dis Transpl 2002; 13: 60\u201362.","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.6.1126"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(98)00139-2"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000743"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.196.3.7644631"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X211051429"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2013.28.2.251"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/112972981001100216"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199910000-00037"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.7.997"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.5758\/kjves.2013.29.2.71"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfs017"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1769765"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/153857449803200420"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.4103\/0022-3859.194221"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261424636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298261424636","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298261424636","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:48:07Z","timestamp":1784530087000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298261424636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/11297298261424636"],"URL":"https:\/\/doi.org\/10.1177\/11297298261424636","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}