Document Detail

Anastomotic strategies to improve hemodialysis access patency--a review.
MedLine Citation:
PMID:  15806274     Owner:  NLM     Status:  MEDLINE    
The number of patients with end-stage renal disease (ESRD) who require maintenance hemodialysis has risen sharply in the past 2 decades. It is estimated that more than 60% of all patients with ESRD who require chronic hemodialysis are accessed through an arteriovenous fistula (AVF) or graft (AVG), and the incidence is increasing at a rate of 2% to 4% per year. The long-term patency rate of an upper extremity AVF or AVG for hemodialysis access remains suboptimal owing in part to progressive stenosis at the venous anastomosis. This article reviews the causative factors of dialysis access-related anastomotic stenosis, or intimal hyperplasia. This article also reviews the clinical experience of various anastomotic strategies to ameliorate the hemodynamic environment in an effort to improve the clinical outcome of hemodialysis access. These strategies include the use of (1) vein cuff at the expanded polytetrafluoroethylene (ePTFE)-venous anastomosis of AVG, (2) cuffed ePTFE dialysis AVG, and (3) anastomotic devices that create an interrupted anastomosis with staples or clips.
Peter H Lin; Ruth L Bush; Liz Nguyen; Marlon A Guerrero; Changyi Chen; Alan B Lumsden
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  39     ISSN:  1538-5744     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-04-04     Completed Date:  2005-07-26     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  135-42     Citation Subset:  IM    
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston VAMC (112), 2002 Holcomb Blvd, Houston, TX 77030, USA.
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MeSH Terms
Arteriovenous Shunt, Surgical / instrumentation*,  methods*
Blood Vessel Prosthesis
Kidney Failure, Chronic / therapy
Renal Dialysis / methods*
Surgical Instruments
Vascular Patency*
Reg. No./Substance:

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