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A successful functioning vascular access is the “lifeline” for a hemodialysis patient. Hemodialysis vascular access dysfunction is a major cause of morbidity and mortality in hemodialysis patients1-3. Improving vascular access outcomes remains an ongoing challenge for nephrologists, vascular access surgeons, and interventionists. In arteriovenous fistulas (AVF) and grafts (AVG), the most common...

Arteriovenous graft (AVG) a. Regular Access Blood Flow (Qa) or Doppler ultrasound stenosis (DUS) screening increases the detection of AVG stenosis compared to dynamic venous pressure (DVP)/clinical examination. (Level II evidence) b. Regular Qa screening with pre-emptive angioplasty does not reduce AVG thrombosis or prolong AVG survival. (Level I & II evidence) c. Whether regular DUS screening ...

Patients with acute kidney failure (AKF) and chronic kidney failure (CKF) require an appropriate vascular access for hemodialysis [1]. Vascular access is needed to allow blood flow through an extracorporeal circulation system with a blood pump connected to a hemodialysis monitor driving the blood through a dialysis filter (dialysator). Satisfactory levels of blood flow range between 300 and 400...

Dr. Steve J. Schwab (Vice-Chairman, Department of Medicine, Duke University Medical Center, and Professor of Medicine, Duke University School of Medicine, Durham, North Carolina, USA): This case exemplifies the current state of the art for the management of vascular access for hemodialysis. The predominant form of vascular access currently in the United States is the polytetrafluoroethylene (PT...

Nephrologists need to deal with the problem of vascular access management in the same manner as the other major problems that affect our dialysis patients. We need to become experts in vascular access and we need to occupy a pivotal position in directing the decisions that are made that affect dialysis patient welfare. An integrated vascular access management strategy is required. Optimally, th...

A progressive rise in the number of patients accepted for renal replacement therapy has been reported world wide [1]. Permanent vascular access (VA) is the life-line for the majority of these patients, when hemodialysis is the treatment of choice. Thus, the successful creation of permanent vascular access and the appropriate management to decrease the complications is mandatory. A well function...

Approximately 1 in every 1000 patients undergoing laparoscopic abdominal surgery will experience bowel or vessel perforation injury by trocars during initial access.1 A systematic review of studies found no conclusive evidence that any one method of gaining initial access and establishing pneumoperitoneum during laparoscopic surgery is safer or more efficacious than another.2 While injuries occ...

Methods Consecutive patients (N 1⁄4 128) having previously undergone CABG surgery and referred for cardiac catheterization were randomized to radial or femoral access. The primary study endpoint was contrast volume. Secondary endpoints included fluoroscopy time, procedure time, patient and operator radiation exposure, vascular complications, and major adverse cardiac events. Analyses were by in...