By Luc Turmel-Rodrigues
This is the 1st textbook solely devoted to the endovascular remedy of issues on the topic of arteriovenous accesses for hemodialysis (native fistulas and prosthetic grafts). The publication addresses the anatomy of higher limb arteries and veins in addition to the medical presentation of sufferers and how to accomplish and skim a fistulogram. Many info and illustrations are supplied, clarifying the subtleties in catheterization and the dilation of stenoses. From a strategic perspective, it's defined for the 1st time that many stenoses needs to both be neglected or intentionally underdilated. A wealth of pictures is helping to appreciate the various phases of entry restoration from thrombosis. because the variety of incident dialysis sufferers is expanding through five% each year, this can be a box of growing to be curiosity. In testomony to this there are numerous annual or bi-annual conferences held via a variety of nationwide and overseas societies (vascularaccesssociety.com, sfav.org, vasamd.org, dialysiscontroversies.org, asdin.org).
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Additional info for Diagnostic and Interventional Radiology of Arteriovenous Accesses for Hemodialysis
19 (a) CO2 venography showed evidence of a moderate stenosis in the forearm cephalic vein. Many surgeons would have considered that it was a contraindication for creation of a wrist radial–cephalic fistula. (b) The surgeon nevertheless created a distal fistula which was referred 2 months later for insufficient maturation. (c) The stenosis was successfully dilated and the fistula used next day for dialysis surgeon. Some prefer that the radiologist offers advice as to the type of vascular access possible in a particular case, while others may see this is as turf intrusion.
This allows certain basic questions that may have safety implications to be answered: known allergy to iodinated contrast, hepatitis and retroviral serology status, list of medications the patients are on, comorbidities, and need for neuroleptanalgesia so that prior anesthesiology referral can be made. Data on the vascular access history, inclusive of information on the most recent surgical and endovascular interventions, are equally important and of necessity but not mandatory as not all dialysis centers have the same level of rigor with archiving such data.
38 6 Indications and Imaging Modalities in Dialysis Access References 1. National Kidney Foundation’s KDOQI (2006) Clinical Practice guidelines for vascular access. Am J Kidney Dis 48(suppl 1):S176–273 2. Tessitore N, Mansucto G, Bedogna V et al (2003) A prospective controlled trial on effect of percutaneous transluminal angioplasty on functioning arteriovenous fistulae survival. J Am Soc Nephrol 14:1623–1627 3. Franco G (2003) Technique and results of duplex-Doppler for non-stenosing complications of vascular access for chronic hemodialysis: ischemia, steal, high flow rate, aneurysm.
Diagnostic and Interventional Radiology of Arteriovenous Accesses for Hemodialysis by Luc Turmel-Rodrigues