Interventional Radiology in Hemodialysis Fistulae and Grafts: A Multidisciplinary Approach

Turmel-Rodrigues, Luc; Pengloan, J; Bourquelot, P

doi:10.1007/s00270-001-0082-y

Cited by 81 publications

(64 citation statements)

References 73 publications

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“…Slight overdilation (by approximately 10 -20 %) is recommended for treatment via percutaneous angioplasty (PTA). In the case of minimal dilation, there are increased recurrent stenoses with correspondingly lower long-term patency [61]. There are possible indications for additional stent implantation in the case of an insufficient PTA result and central venous stenoses and in the case of complications such as dissections or vascular perforations [62,63].…”

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confidence: 99%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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A wide variety of diagnostic and minimally invasive modalities is currently available to radiologists for providing sufficient medical care for dialysis patients. In addition to clinical examination, ultrasound is the first line imaging method in suspected dialysis vascular access dysfunction. The percutaneous approach is the primarily recommended therapeutic option in many cases. This article reviews the current diagnostic and therapeutic methods in dialysis vascular access insufficiency. Key Points: ??Vascular access dysfunction is often elicited by stenosed vessels, which are regularly associated with concomitant thrombosis. ??Stenoses are commonly observed in the anastomosis, vascular access vein and also in the central venous system. ??Beside the clinical examination, sonography is the diagnostic method of first choice. ??Percutaneous balloon dilatation frequently is the first treatment option. Citation Format: ??Kamper L, Faizy TD, Haage P. Diagnosis and Treatment of Insufficient Dialysis Vascular Access. Fortschr R?ntgenstr 2015; 187: 360???371

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confidence: 99%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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“…the entire length of the artery from the origin from the aorta to the arteriovenous anastomosis, the arteriovenous anastomosis (in the case of AVG, the entire graft), and the central vein (draining vein)up to the confluence with the vena cava. 13,18,20,21,30,38,49,78,93 The types of lesions considered to be targets are stenosis, lesions requiring treatment, including both thrombotic and non-thrombotic occlusions. However, in cases involving a central artery or vein, which are likely to require emergency hemostasis if the blood vessel is damaged, each medical facility must determine whether VAIVT is indicated based on the facility s abilities, including whether they have covered stents for hemostasis or surgical backup available.…”

Section: Subjects and Indicationsmentioning

confidence: 99%

“…As a result, the thrombus tends to form within the graft. 20,25,32 In order to ensure satisfactory inflow and outflow in such cases, sheaths are inserted from opposite sides of the graft on the upstream and downstream sides to perform PTA and thrombectomy. In cases in which the sheath insertion sites are limited and lesions are present on the upstream and/or downstream sides, it may be difficult to insert two sheaths.…”

Section: Avgmentioning

confidence: 99%

“…51,69,76 For lesions expected to have poor expandability, such as in cases of recurrence of previous lesions with poor expandability or lesions located in AVG venous anastomosis sites, the use of ultrahigh pressure-resistant balloon catheters designed to withstand up to 30 atm or cutting balloon catheters may be considered. 1,19,20,29 However, since balloon catheter dilation straightens the blood vessel, use on lesions that have pronounced curves is contraindicated.…”

Section: Characteristics Of Va Stenosismentioning

confidence: 99%

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Guidelines for basic techniques in vascular access intervention therapy (VAIVT)

Matsuura

Gotoh²,

Sadaoka

et al. 2018

Interventional Radiology

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Vascular access intervention therapy (VAIVT) is an interventional therapy that is an essential part of dialysis as it allows for long-term continuous vascular access (VA). This Guideline is intended to serve as an aid for solving of actual technical problems encountered when performing VAIVT. After reviewing the basics of VAIVT, we listed the various VAIVT techniques in clinical question (CQ) format and provided descriptions. Specifically, these descriptions contain the indications, contraindications, VA tests, methods of using VAIVT devices, complications associated with VAIVT, and most of the issues related to VAIVT measures and practices. We also ensured that contents were consistent with the Guideline of Vascular Access Construction and Repair for Chronic Hemodialysis produced by the Japanese Society for Dialysis Therapy. We hope that this Guideline is useful to medical practitioners involved in VAIVT and contribute to maintaining vascular access for dialysis patients.

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“…As a result of neointimal proliferation, recurrent restenoses occur even when using a stent for in-stent stenosis 20 . To date, there is no better method than PTA, even though this has been modified (ultrahigh pressure balloons 21 , cutting balloons 22 , external beam radiation therapy 23 .…”

Section: Introductionmentioning

confidence: 99%

Arteriovenous graft for hemodialysis, graft venous anastomosis closure - current state of knowledge. Minireview

Bachleda¹,

Utíkal²,

Köcher³

et al. 2015

BIOMED PAP

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aBackround. The use of artificial vascular grafts (arteriovenous graft, AVG) is indicated in patients in hemodialysis programs if the subcutaneous venous bed is exhausted or unsuitable for arteriovenous fistula (AVF) creation. The native fistula should be the hemodialysis access of first choice: AVF has better results in terms of function and potential complications. However, the use of AVG is necessary in some patients. In these patients, extensive clinical examination, color duplex sonography and angiography should be performed prior to indication. The technique of graft implantation requires respect for geometric relations for the graft anastomoses to minimize the formation of intimal hyperplasia mainly on the venous anastomosis. The main complications of AVG are stenosis on the venous anastomosis (VAG), causing closure of graft and graft infection. The cumulative function of AVG is 59-90% in the first year and 50-82% in the second year. Arteriovenous graft stenosis leading to thrombosis is a major cause of complications in patients undergoing hemodialysis. The purpose of this review is to summarise current knowledge of the diagnostics and treatment of graft thrombosis and discuss the issue in combination with relevant publications via Pubmed database. Conclusion. The most frequent cause of failure of AVG for hemodialysis is stenosis and closure by VAG. AVG closure can be addressed surgically, endovascularly (amenable to thrombectomy by radiological or surgical means) and by hybrid performance.

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Interventional Radiology in Hemodialysis Fistulae and Grafts: A Multidisciplinary Approach

Abstract: Radiology achieves results comparable with surgery, with minimal invasiveness and better venous preservation. However, wide variations in the results suggest that the degree of commitment of physicians might be as important as the type of technique used.

Cited by 81 publications

References 73 publications

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Guidelines for basic techniques in vascular access intervention therapy (VAIVT)

Arteriovenous graft for hemodialysis, graft venous anastomosis closure - current state of knowledge. Minireview

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