Arterial reconstructions of kidney allograft

Vildanov, S. R.; Nykonenko, A. O.; Русанов, І. В.; Nykonenko, O. S.

doi:10.14739/2310-1210.2017.1.91633

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Найбільш поширеним видом замісної ниркової терапії у всьому світі, на сьогоднішній день, є програмний гемодіаліз [1]. Для ефективного лікування гемодіалізом пацієнту необхідний добре функціонуючий та стабільний судинний доступ.…”

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Thrombectomy in Patients With Thrombosis of Arterio-Venous Fistula: Case Series

Vildanov

Nykonenko

Gubka

et al. 2023

Modern Medical Technology

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Introduction. Thanks to the use of renal replacement therapy at the current stage of medical development, complete medical and social rehabilitation of patients with end-stage chronic renal failure is possible. The key to effective programmed hemodialysis is the formation of adequate permanent vascular access. Ensuring the optimal use and functioning of permanent vascular access is a multidisciplinary challenge. Currently, none of the known options for permanent vascular access is ideal, but a native arteriovenous fistula meets the requirements to a greater extent. Complications from vascular access for hemodialysis remain relevant for their solution today. The most common complication of vascular access is thrombosis of an arteriovenous fistula. For patients with chronic renal failure who are on programmed hemodialysis, thrombosis of vascular access is a great danger, which ultimately can lead to the impossibility of further hemodialysis and is the main reason for hospitalization and high mortality of this contingent of patients and needs an urgent solution. Clinical cases. 17 patients underwent thrombectomy from the subcutaneous "fistula". vein of the upper extremity. The age of the patients was 49.0 (44.0-61.0) years. By gender, the studied patients were distributed as follows: women - 9 (53%), men - 8 (47%). Among 17 (100%) operated patients, 12 (71%) had late thrombosis, 5 (29%) had early thrombosis of arteriovenous fistula,. Of 5 (100%) patients with early thrombosis of arteriovenous fistula, thrombectomy was effective in 2 (40%) patients (p=0.038). On the other hand, in 12 (100%) patients with late thrombosis of arteriovenous fistula, thrombectomy was successful in only 4 (33%) cases. Discussion. The cause of thrombosis of any vascular anastomosis is primarily hyperplasia of the neointima due to the proliferation of smooth muscle cells of the vascular wall. This circumstance leads to the formation of stenosis of the anastomosis, and as soon as the stenosis values become hemodynamically significant (> 50% of the lumen of the vessel), the risk of developing thrombosis increases by more than 50%. Thrombectomy alone is insufficient to restore patency of the permanent vascular access in the long term, as flow-limiting stenosis is present in more than 85% of cases. Conclusions. Neointimal hyperplasia is the main cause of progressive stenosis of arteriovenous fistula and subsequent thrombosis. Thrombectomy is indicated for thrombosis of arteriovenous fistula in the early postoperative period (up to 30 days after arteriovenous fistula formation). Thrombectomy alone is not enough to restore the patency of the permanent vascular access in the long term, and the final treatment requires its reconstruction at an early stage or the creation of a new arteriovenous fistula.

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Section: вступunclassified

Thrombectomy in Patients With Thrombosis of Arterio-Venous Fistula: Case Series

Vildanov

Nykonenko

Gubka

et al. 2023

Modern Medical Technology

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“…Незважаючи на те, що трансплантація нирки являється методом вибору в лікуванні хворих з термінальною стадією хронічної ниркової недостатності [1], програмний гемодіаліз на сьогодні є найпоширенішим методом лікування цієї категорії пацієнтів. Варіантом вибору постійного судинного доступу для гемодіалізу є артеріовенозна фістула.…”

Section: вступunclassified

The I Nfluence of Intrаdiаlytic Hypotension on the Functioning of Аrteriovenousfistulа

Nykonenko¹,

Vildanov²

2021

Khark. Surg. Sch.

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Introduction. Nowadays hemodialysis is the most widespread way of treatment concerning the end-stage renal disease. The variant of choice as for permanent vascular access for hemodialysis is arteriovenous fistula. An actual problem is the deterioration of the patency of arteriovenous fistula. According to the research, most patients do not know about the risks associated with intradialytic hypotension. Under these conditions, research with determining the level of critical intradialytic hypotension is particularly relevant. Purpose of the work is to study and evaluate intradialytic hypotension as a risk factor for thrombosis of arteriovenous fistulas. Materials and methods. 60 patients were examined with end-stage renal disease, receiving of hemodialysis. Among these patients a thrombosis of arteriovenous fistula appeared in the long term (7.5 (3.0–17.6) months) after the surgery. The average age of patients was (54.1 ± 11.8) years; there were 30 (50%) men, 30 (50%) women. Results. According to the results of our study, 38 (63 %) patients had hypotension at the end of the hemodialysis session. Conclusions. Blood hypotension is one of the main predictors of thrombosis of arteriovenous fistula in the late postoperative period. A decrease in systolic blood pressure on 35.0 (25.0–50.0) mm Hg to 100.0 (90.0–110.0) mm Hg is critical for the patency of arteriovenous fistula. Adequate control and correction of blood pressure (in particular, during a hemodialysis session) can prevent thrombosis of arteriovenous fistula.

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Arterial reconstructions of kidney allograft

Cited by 2 publications

References 19 publications

Thrombectomy in Patients With Thrombosis of Arterio-Venous Fistula: Case Series

Thrombectomy in Patients With Thrombosis of Arterio-Venous Fistula: Case Series

The I Nfluence of Intrаdiаlytic Hypotension on the Functioning of Аrteriovenousfistulа

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