Hemodialysis vascular access dysfunction and its endovascular treatment

Česká verzia

Authors: Martin Vorčák ¹; Kamil Zeleňák ¹; Ján Sýkora ¹; Alena Ježíková ²; Marián Mokáň ²
Authors place of work: Rádiologická klinika JLF UK a UN Martin, Slovenská republika ¹; I. Interná klinika JLF UK a UN Martin, Slovenská republika ²
Published in the journal: Vnitř Lék 2020; 66(6): 14-18
Category:

Summary

Hemodialysed patients with end stage renal disease are reliant to proper function of vascular access – mostly arterio-venous fistula (AVF). AVF patency is jeopardized by stenosis formation, which needs to be treated before thrombosis. Angioplasty is primarily indicated and prolongs vascular access patency. High pressure balloons and cutting balloons aid to high technical success rate. Angioplasty needs to be repeated in order to maintain long term patency. Drug-eluting balloons prolong long term patency. Stents and stentgrafts are seldom used in inoperable patients and in selected locations. Technical advances allowed endovascular treatment in AVF thrombosis followed by angioplasty of culprit lesion. Vascular access endovascular occlusion is alternative for surgery in inoperable patients. In patients with residual renal function or iodine allergy, intervention could be ultrasound guided or carbon dioxide could be used without the need of iodine contrast.

Keywords:

Angioplasty – arterio-venous fistula stenosis – central venous stenosis – endovascular treatment – hemodialysis

Zdroje

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