Management of complications of endovascular dialysis access procedures

Area of Science:

• Interventional Radiology
• Nephrology
• Vascular Surgery

Background:

• Endovascular procedures are increasingly standard for managing hemodialysis vascular access dysfunction.
• These interventions, while effective, carry inherent procedure-related risks and complications.

Purpose of the Study:

• To outline common and unique complications associated with endovascular procedures for hemodialysis vascular access.
• To discuss the management strategies for these potential complications.

Main Methods:

• Review of complications associated with angioplasty during endovascular procedures.
• Analysis of complications specific to endovascular thrombectomy, including angioplasty.
• Discussion of clinical significance and management pathways for identified complications.

Main Results:

• Vein rupture/tearing is the most frequent angioplasty-related complication, with variable clinical significance.
• Symptomatic peripheral artery embolus is a major complication unique to endovascular thrombectomy.
• Most complications, including emboli, can be managed effectively through endovascular techniques.

Conclusions:

• Interventionalists must be prepared to manage endovascular procedure complications effectively.
• Appropriate management of complications is essential for successful hemodialysis vascular access maintenance.
• Understanding complication frequencies and management optimizes patient care.