Sharp Needle Recanalization for Salvaging Hemodialysis Accesses with Chronically Occluded Peripheral Outflow

Abstract

Sharp needle recanalization is an effective percutaneous treatment for restoring function to hemodialysis accesses with chronically occluded venous outflow pathways.

Editor's Choice – Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)

“…This includes sharp needle recanalisation of the outflow vein if experienced radiological support is available. 616 If recanalisation using endovascular techniques fails then the next option could be a bypass using a prosthetic conduit onto the ipsilateral axillary/subclavian 617 ( Fig. 8a).This chest wall surgery uses exposures identical to the ipsilateral axillary artery e vein loop 618,619 and ipsilateral axillary artery e jugular vein loop (Fig.…”

Chronically Occluded Arteriovenous Fistula Salvaged by Sharp Needle Recanalization

“…Since these early reports, there have been a number of additional publications using this technique to either establish a pathway for the placement of a catheter , reestablish central venous circulation, or reestablish outflow in an obstructed hemodialysis access . Most of these reports have been anecdotal single case reports or a relatively small series of cases.…”

Endovascular bypass for salvage of vascular access in hemodialysis catheter-consigned patients

“…In addition to having higher infection and dysfunction rates than other types of vascular access, hemodialysis catheters may be inconvenient. 1 With recent advances in endovascular techniques, [2][3][4][5] these abandoned vascular access sites with selected access anatomy can be salvaged with the creation of an intervascular tunnel. We herein report the results of endovascular bypass for the treatment of 16 patients whose vascular access sites were abandoned because of (1) poor or no outflow veins characterized by thrombosis and hand swelling or (2) a deeply seated cannulation vein after inadequate elevation surgery.…”