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HEMODİYALİZ VASKÜLER ERİŞİM YOLU KOMPLİKASYONLARINDA RADYOLOJİK TANI VE TEDAVİ

RADIOLOGICAL DIAGNOSIS AND TREATMENT IN HEMODIALYSIS VASCULAR ACCESS COMPLICATIONS

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Abstract (2. Language): 
In the hemodialysis vascular accesses, stenosis in the anastomosis and draining veins are the most common dysfunctioning pathologies, whereas thrombosis is the most common reason of access loss. Angiographic examinations (contrast fistulography and venography) are gold standart techniques in the evaluation of vascular access complications. Color Doppler sonography is another modality for the detection of these complications. It is a noninvasive and inexpensive technique, but this modality depends on experience and skill of the sonographer. Color Doppler sonography has a high sensitivity in the detection of the thrombosis, pseudoaneurisms and arterial stenooclusive lesions. Interventional radiological approach to the dysfunctioning vascular accesses (percutaneous transluminal balloon angioplasty, stent implantation, reposition of catheters and removal of fibrin sheats) provides safe and effective treatment alternatives and shortens the hospital stay.
Abstract (Original Language): 
Hemodiyaliz vasküler erişim yollarında en sık disfonksiyona neden olan patolojiler, anastomoz ve drenaj venlerini ilgilendiren stenozlardır. Akses kayıplarının en sık nedeni ise trombotik komplikasy onlar dır. Hemodiyaliz vasküler akseslerinin, komplikasyonlar yönünden değerlendirilmesinde anjiografik incelemeler (kontrast fıstülografı ve venografı) altın standarttır. Bu tip kompliksyonların saptanmasında kullanılan diğer modalite olan renkli Doppler ultrasonografı noninvaziv ve ucuz bir yöntemdir, ancak kullanıcının bilgi ve tecrübesine bağımlıdır. Renkli Doppler ultrasonografı, özellikle trombozlarda, vasküler aksesi besleyen arteriyelsistemin değerlendirilmesinde ve psödoanevrizmaların saptanmasında yüksek sensitiviteye sahiptir. Hemodiyaliz vasküler akses komplikasyonlarının tedavisinde uygulanan perkütan girişimsel radyolojik işlemler (PTA, stent implantasyonu, kateter repozisyonları, kateter fibrin kılıf uzaklaştırılması), hastanede yatış süresini kısaltan ve etkin tedavi sağlayan güvenilir yöntemlerdir.
FULL TEXT (PDF): 
166-176

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