Advances in Endovascular Salvage.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Nephrology

Background:

• Endovascular salvage is vital for maintaining dialysis access.
• Recurrent stenosis is a common complication requiring intervention.

Purpose of the Study:

• To review current endovascular techniques for dialysis access salvage.
• To highlight the role of various angioplasty balloons, stents, and stent grafts.

Main Methods:

• Review of angioplasty with standard, high-pressure, ultrahigh-pressure, cutting, and drug-eluting balloons.
• Discussion of stent and stent graft applications in specific access segments.
• Emphasis on physical examination, bedside ultrasound, and angiographic evaluation.

Main Results:

• Standard angioplasty is the primary therapy.
• Cutting balloons and drug-eluting balloons show promise for specific stenosis types.
• Stents and stent grafts are useful for remodeling-prone segments.

Conclusions:

• Successful dialysis access management involves preserving venous real estate and utilizing a range of endovascular tools.
• Knowledgeable evaluation of the access is critical for optimal outcomes.