Strategies of arteriovenous dialysis access

Seminars in Vascular Surgery
Jonathan M WeiswasserAnton N Sidawy

Abstract

Surgical management of the patient who requires hemodialysis access, while continuing to demand more attention from the vascular surgeon, suffers from discrepancies of approach and strategy. With the increase in incidence of dialysis dependent renal failure among our population, many have attempted to present a uniform, logical strategy with which the vascular surgeon can most effectively treat the hemodialysis patient in the long term. Most notably, the multidisciplinary Dialysis Outcomes Quality Initiative (DOQI) guidelines present the surgeon with a rough outline of hemodialysis access insertion strategy, and it has become nationally recognized as an acceptable summary of treatment strategy and goals. The decision as to the most appropriate surgical access to offer a patient depends on immediate need for hemodialysis, history and physical examination findings, and suitability of available veins in the extremity. While percutaneous, catheter based access affords the luxury of immediate access, these devices suffer from several complicating factors, such as infection, and damage to large, proximal veins. For long-term access, the autogenous access, while perhaps less successful in the immediate short term, is always the prefer...Continue Reading

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Citations

Jul 3, 2013·Indian Journal of Nephrology·P SahasrabudheS Patil
Sep 24, 2015·AJR. American Journal of Roentgenology·Keith Bertram Quencer, Melih Arici
Apr 3, 2013·Journal of Vascular Surgery·Lori L Pounds, Victoria J Teodorescu
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Apr 13, 2021·Indian Journal of Nephrology·R VenkatnarayananAsish Kumar Mondal
May 10, 2017·Annals of Vascular Surgery·Matthew ThomasMonica Hansrani

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