Buradasınız

Anasayfa » Content

HEMODİYALİZ VASKÜLER ERİŞİM YOLU KOMPLİKASYONLARINDA RADYOLOJİK TANI VE TEDAVİ

RADIOLOGICAL DIAGNOSIS AND TREATMENT IN HEMODIALYSIS VASCULAR ACCESS COMPLICATIONS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2002

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
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.
Bookmark/Search this post with
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): 
PDF icon pdf_tndt_399.pdf
  • 3
166-176
  • Turkish

REFERENCES

References: 

1.
Trerotol
a OS, Scheel PJ, Zibari GB, Mcdonald JC. Hemodialysis access management. In: Trerotola OS and Savader JS. Venous Interventional Radiology with Clinical perspectives. New York, Thieme. 1996.
2. Middleton WD, Picus DD, Marx MV, Melson GL. Color Doppler Sonography of hemodialysis Vascular access: Comparison with angiography. AJR 152:633-639, March 1989.
3. Shackleton CR, Taylor DC, Buckley AR, et al.
Predicting failure in polytetrafluoroethylene vascular access grafts for hemodialysis: a pilot study. Can J Surg. 1987Nov;30(6):442-4.
4. Dousset V, Grenier N, Douws C, et al. Hemodialysis grafts: color Doppler flow imaging correlated with digital subtraction angiography and functional status. Radiology. 1991 Oct;181(l):89-94.
5. Kottle SP, Gonzalez AC, Macon EJ, Fellner SK.
Ultrasonographic evaluation of vascular access
complications. Radiology. 1978 Dec;129(3):751-4.
6. Strauch BS, O'Connel RS, Geoly KL, et al. Forecasting thrombosis of vascular access with Doppler color flow
imaging. Am J Kidney Dis.l992Jun;19:554-7.
7. Rittgers S, Garcia-Valdez C, McCormick J, Posner M. Noninvasive blood flow measurement in expanded polytetrafluoroethylene grafts for hemodialysis access. J Vase Surg. 1986 Apr;3(4):635-42.
8. Sands J, Young S, Miranda C. The effect of Doppler flow screening studies and elective revisions on dialysis
access failure. ASAIO J. 1992 Jul-Sep;38(3):M524-7.
9. Surrat RS, Picus D, Hicks ME, Darcy MD, Kleinhoffer
M, Jendrisak M. The importance of preoperative evaluation of the subclavian vein in dialysis access planning. AJR Am J Roentgenol 1991; 156: 623-625.
10. Patel MC, Berman LH, Moss HA, McPherson S J.
Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as
175
a predictor of complete central occlusion. Radiology. 1999May;211(2):579-83.
11. England RE, Jackson A. Imaging of dialysis access: a review of 67 failing fistulas investigated by intravenous digital subtraction angiography. Br J Radiol. 1993 Jan;66(781):32-6.
12. Baum S. Abram' s Angiography, Vascular and interventional radiology. Lipincott-Raven Publishers. 1998.
13. Haskal JZ, Leen VH, Thomas-Hawkins C, Shlansky-Goldberg RD, et al. Transvenous removal of fibrin sheats from tunneled hemodialysis catheters. AJR 1999; 173 (4): 1023-7.
14. Kwun KB, Schanzer H, Finkler BA, et al. Hemodynamic evaluation of angioaccess procedures of
hemodialysis. Vase Surg 1979;13:170-177.
15. Valji K, Hye RJ, Robert AJ, et al. Hand ischemia in patients with hemodialysis access grafts: angiographic diagnosis and treatment.
Radiology. 1995 Sep;196(3):697-701.
16. Berkoben M, Schwab SJ. Hemodialysis vascular access. In: Henrich WL. Principles and Practice of Dialysis. Second edition, Baltimore, Maryland / USA,
Williams & Wilkins. 1999.
17. Zibari GB, Rohr MS, landreneau MD, et al.
Complications from permanent hemodialysis vascular
access. Surgery. 1988 Oct;104(4):681-6.
18. Ballard JL, Bund TJ, Malone JM. Major
complications of angioaccess surgery.
Am J Surg. 1992 Sep;164(3):229-32.
19. Mattson WJ. Recognition and treatment of vascular steal secondary to hemodialysis prostheses. Am J Surg. 1987 Aug; 154(2): 198-201.
20. Anderson CB, Etheredge EE, Harter HR, et al. Blood flow measurements in arteriovenous dialysis fistulas. Surgery. 1977 Apr;81(4):459-61.
21. Schwab SC, Raymond JR, Saeed M, et al. Prevention of hemodialysis fistula thrombosis. Early detection of
venous stenoses. Kidney Int. 1989 Oct;36(4):707-11.
22. Palder SB, Kirkman RL, Whiltemore AD, et al.
Vascular access for hemodialysis: patency rates and results of revisions. Ann Surg 1985;202(2):235-239.
23. Bone GE, Pomajzl MJ. Management of dialysis fistula
thrombosis. Am J Surg 1979;178:901-906.
24. Davis GB, Dowd CF, Bookstein JJ, Maroney TP, Lang EV, Halasz N. Thrombosed dialysis graft: efficacy of intrathrombic deposition of concentrated urokinase, clot maceration, and angioplasty. AJR Am J Roentgenol
1987;149: 177-181.
25. Smith TP, Cragg AH, Castaneda F, Hunter DW.
Thrombosed PTFE hemodialysis fistulas: salvage with combined thrombectomy and angioplasty. Radiology
1989; 171:507-508.
26. Anderson JT, Gammelgaard J, Nielson LM, Clausen E. Subclavian vein catheterization for acute and chronic hemodialysis: a safe temporary vascular access. Int
Urol Nephrol 1986;18:327-332.
27. Vanherweghem JL, Cabulet P, Dhane M, et al. Subclavian vein thrombosis: a frequent complication of subclavian vein cannulation for hemodialysis. Clin
Nephrol. 1986 Nov;26(5):235-8.
28. Vanholder R, Lameire N, Verbanck J, et al. Complications of subclavian catheter hemodialysis: a 5 year prospective study in 257 consecutive patients. Int J
Artif Organs. 1982 Sep;5(5):297-303.
29. Barret N, Spencer S, Mclvor J, Brown EA. Subclavian stenosis: a major complication of subclavian catheters.
Nephrol Dial Transplant 1988;3:423-425.
30. Schillinger F, Schillinger D, Montagnac R, Milcent T. Post-catheterization venous stenosis in hemodialysis: comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrologie. 1992; 13 (3):127-33.
31. Glanz S, Gordon DH, Lipkowitz GS, et al. Axillary and subclavian vein stenosis: percutaneous angioplasty.
Radiology. 1988 Aug;168(2):371-3.
32. Bander SJ, Schwab SJ. Central venous angioaccess for hemodialysis and its complications. Semin Dial 1992;5
(2) :121-128.
33. Beathard G. Percutaneous transvenous angioplasty in the treatment of vascular access stenosis. Kidney Int
1992; 42: 1390-1397.
34. Etheredge EE, Haid SD, Maeser MN, Sicard GA,
Anderson CB. Salvage operations for malfunctioning PTFE hemodialysis access grafts. Surgery 1983; 94
(3) :464-470.
35. Beathard G. Gianturco self-expanding stent in the treatment of stenosis in dialysis access grafts. Kidney
Int 1993; 43: 872-877.
36. Kovalik EC, Newman GE, Suhocki P, Knelson M, Schwab SJ. Correction of central venous stenoses: use of angioplasty and vascular Wallstents. Kidney Int 1994;45:1177-1181.
37. Haage P, Vorwerk D, Piroth W, Schuermann K, Guenther RW. Treatment of hemodialysis-related central venous stenosis or occlusion: Result of primary Wallstent placement and follow up in 50 patient.
Radiology 1999;212:175-180.
38. Mickley V, Görich J, Rilinger N, Storck M, Abendroth
D. Stenting of central venous stenoses in hemodialysis patients: long-term results. Kidney Int 1997;51:277-280.
39. Glanz S, Gordon D, Butt K, Hong J, Lipkowitz G. The role of percutaneous angioplasty in the management of chronic hemodialysis fistulas. Ann Surg 1987; 206(6): 777-781.
40. Saeed M, Newman GE, Mccan RL, Sussman SK, Braun SD, Dunnick NR. Stenoses in Dialysis Fistulas: Treatment with Percutaneous Angioplasty. Radiology
1987; 164:693-697.
41. Kanterman RY, Vesely TM, Pilgram TK, Guy BW, Windus DW, Picus D. Dialysis access grafts: Anatomic Location of Venous stenosis and Results of
Angioplasty. Radiology 1995; 195:135-139.
42. Beathard G. Percutaneous transvenous angioplasty in the treatment of vascular access stenosis. Kidney Int
1992; 42: 1390-1397.

Thank you for copying data from http://www.arastirmax.com