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Avoiding hemodialysis access-induced distal ischemia
Vernon D Horst1, Peter R Nelson1, Alexandros Mallios2
1Division of Vascular Surgery, Department of Surgery, School of Community Medicine, The University of Oklahoma, Tulsa, OK, USA.
The Journal of Vascular Access
|July 28, 2020
Summary
Identifying patients at risk for hemodialysis access-induced distal ischemia (HAIDI) is crucial. Pre-operative assessment helps create safe vascular access, preventing serious complications for end-stage renal disease patients.
Area of Science:
- Nephrology
- Vascular Surgery
- Radiology
Background:
- Vascular access is vital for hemodialysis in end-stage renal disease (ESRD).
- Hemodialysis access-induced distal ischemia (HAIDI) is a significant complication of arteriovenous fistulas and grafts.
- Preventing HAIDI is preferable to managing established complications.
Purpose of the Study:
- To review characteristics identifying patients at risk for HAIDI.
- To provide recommendations for pre-operative assessment to mitigate HAIDI risk.
- To suggest vascular access options and techniques for at-risk patients.
Main Methods:
- Review of patient medical and surgical history.
- Physical examination for risk stratification.
- Imaging studies to assess vascular anatomy.
- Analysis of pre-operative factors associated with HAIDI.
Main Results:
- Identification of specific patient profiles at higher risk for HAIDI.
- Correlation between pre-operative assessment findings and HAIDI development.
- Evaluation of various vascular access strategies for risk reduction.
Conclusions:
- Comprehensive pre-operative evaluation is key to identifying patients susceptible to HAIDI.
- Tailored vascular access planning can prevent distal ischemia in at-risk hemodialysis patients.
- Proactive risk assessment improves outcomes and patient safety in ESRD vascular access creation.
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