Document Detail

Approach to patients with "complex" hemodialysis access problems.
MedLine Citation:
PMID:  12535297     Owner:  NLM     Status:  MEDLINE    
The approach to patients with "complex" permanent hemodialysis (HD) access problems remains poorly defined. The purpose of this review is to outline our current algorithm for patients presenting for dialysis access and to address the management of specific problems that complicate this objective of establishing permanent access. The key components of the algorithm include noninvasive imaging in the diagnostic vascular laboratory to determine all the possible access configurations and invasive imaging with both venography and arteriography to confirm the optimal choice. The specific access-related problems addressed include inadequate ipsilateral vein, inadequate arterial inflow, central vein stenosis/occlusion, multiple previous access failures, and obesity. Despite the label of "complex" access problems, it is possible to construct native arteriovenous fistulas (AVFs) in almost all patients presenting for access using the standard principles of vascular surgery that are based on establishing adequate arterial inflow, adequate venous outflow, and selecting an appropriate conduit.
Thomas S Huber; James M Seeger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in dialysis     Volume:  16     ISSN:  0894-0959     ISO Abbreviation:  Semin Dial     Publication Date:    2003 Jan-Feb
Date Detail:
Created Date:  2003-01-21     Completed Date:  2003-05-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-9     Citation Subset:  IM    
Division of Vascular Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
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MeSH Terms
Arm / anatomy & histology,  radiography,  surgery
Arteriovenous Shunt, Surgical / methods*
Blood Vessels / anatomy & histology
Catheters, Indwelling*
Radiographic Image Enhancement / methods
Renal Dialysis / methods*
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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