Challenges 2 Femoral Approach 2 Standard of Technical Excellence 2 Technique The fl uoroscopically guided micropuncture access 3 Technical Tips 4 * * Angiography to check the location of femoral entry through a dilator 4 Preparations in obese patients 4 * Directing the needle 4 * If the wire cannot be inserted 5 * Sequential order for arterial and venous puncture 5 * * Kinked wire 5 * * Punctur...

This review examines four imaging modalities; ultrasound (US), digital subtraction angiography (DSA), magnetic resonance imaging (MRI) and computed tomography (CT), that have common or potential applications in vascular access (VA). The four modalities are reviewed under their primary uses, techniques, advantages and disadvantages, and future directions that are specific to VA. Currently, US is...

Department of Surgery, University Hospital Maastricht, The Netherlands, Nephrology, Dialysis and Intensive Care Unit; Lapeyronie University Hospital, Montpellier, France, Department of Diagnostic and Interventional Radiology, Helios Klinikum Wuppertal, University Hospital Witten/Herdecke, Germany, Medical Faculty University of Cologne, Medicine Clinic I, Hospital Merheim, Germany (retired), Dep...

Reference is made to a personal series of vascular accesses for haemodialysis on 273 patients aged 6 months to 70 yr. During the course of 12 years, 533 operations were performed: 109 cannulations of the saphena, 152 by-pass, 251 arteriovenous fistulae (including 22 on patients under 10 yr of age), and 21 "difficult accesses". An assessment of the advantages and disadvantages of the techniques ...

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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...