Akademik Veri Yönetim Sistemi
Balkan Congress of Radiology, Belgrade, Sırbistan, 19 - 20 Ekim 2023, ss.105-106, (Tam Metin Bildiri)
The Aim:
To investigate the effectiveness of endovascular and percutaneous treatments to preserve the patency of failing hemodialysis arteriovenous fistulas.
Background:
Hemodialysis for patients with end-stage Renal Disease requires well-functioning vascular access. Native arteriovenous fistulae (AVF) are the best and most durable access for hemodialysis. AVF dysfunction is a common reason for vascular access problem in chronically hemodialyzed patients. It is caused by stenosis or occlusion in the inflow artery, anastomosis, or outflow vein. Endovascular and percutaneous strategies have been used to manage patients with AVF dysfunction for hemodialysis.
Clinical Findings/Procedure Details:
In the access failure of a mature AVF, stenosis, thrombus, and aneurysm formation should be investigated with Doppler ultrasonography after insufficient fistula findings are detected in the physical examination. In addition, the flow rate and pressure of the fistula should be checked. In patients for whom endovascular treatment is considered, a fistulography should be performed, and the pathology should be fully demonstrated. Lyse and wait technique and its modifications can be used as a percutaneous treatment method. Endovascular treatment methods can be listed as balloon angioplasty, stent, stent-graft, and mechanical thromboaspiration. Balloon angioplasty is the gold standard treatment for venous stenosis in the KDOQI guideline. Treatment success is evaluated as successful dialysis and restoration of a palpable thrill.
Conclusion:
Endovascular and percutaneous interventions are safe and effective methods in the treatment of AVF dysfunction caused either by stenosis or thrombosis. Preoperative planning has a crucial role in angiographic or clinical success.