Distal revascularization and interval ligation

Distal Revascularization and Interval Ligation (DRIL) is a surgical procedure used to treat symptomatic Dialysis Access Steal Syndrome (DASS). The goal of this surgery is to alleviate the symptoms of DASS, such as pain and numbness in the extremity distal to the access, while preserving the access for hemodialysis. The surgeon creates a bypass around the access and ligates the artery just distal to the access anastomosis, thereby preventing retrograde blood flow from the affected limb. This operation is very effective at reducing symptoms, but it carries a risk associated with ligating a native artery.