کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5728426 1411656 2017 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Strategies for Hemodialysis Access: A Vascular Surgeon's Perspective
ترجمه فارسی عنوان
راهبردهای دسترسی به همودیالیز: چشم انداز جراحان عروقی آکا
کلمات کلیدی
دسترسی به همودیالیز، دسترسی عروقی، از فیستول، از گرافت
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی رادیولوژی و تصویربرداری
چکیده انگلیسی

Problems related to hemodialysis access are a significant cause of morbidity and mortality in patients with end-stage renal disease. Physicians of all specialties who are involved in the placement and maintenance of vascular access for hemodialysis must have a long-term strategy for sequential placement of autogenous fistulas, transpositions, and prosthetic grafts to preserve access sites and to avoid long-term use of tunneled dialysis catheters. The Fistula First and KDOQI initiatives have provided strategies and algorithms for access placement in patients with chronic kidney disease. Preservation of veins should begin before dialysis access is necessary to achieve the goal of creating a primary arteriovenous (AV) fistula or transposition suitable for cannulation when dialysis is initiated. Prosthetic and biologic grafts offer reasonable alternatives when autogenous access is not feasible. Newer graft materials and conduits are under evaluation to improve long-term outcomes. Use of tunneled dialysis catheters should be discouraged and they should be considered a last resort for long-term access. We present a strategy from the perspective of a vascular surgeon for the sequential placement of AV fistulas, venous transpositions, and AV grafts in these challenging patients. We also discuss specific concerns regarding hemodialysis access in difficult patient populations such as the elderly patient and the morbidly obese patient.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Techniques in Vascular and Interventional Radiology - Volume 20, Issue 1, March 2017, Pages 14-19
نویسندگان
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