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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

25
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Related Experiment Video

Updated: Aug 24, 2025

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Transarterial Interventional Therapy for Non-functioning Hemodialysis Access.

Shiro Miyayama1, Masashi Yamashiro1, Natsuki Sugimori1

  • 1Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui, Japan.

Interventional Radiology (Higashimatsuyama-Shi (Japan)
|October 26, 2022
PubMed
Summary

Transarterial vascular access interventional therapy (VAIVT) offers advantages for non-functioning hemodialysis access by enabling observation of venous outflow and treatment via a single arterial route. While effective, potential complications include hematomas and the need for additional venous access in complex cases.

Keywords:
Vascular access interventional therapynon-thrombotic occlusionthrombotic occlusiontransarterial approach

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Area of Science:

  • Interventional Radiology
  • Vascular Surgery
  • Nephrology

Background:

  • Non-functioning hemodialysis access necessitates timely intervention to restore patency.
  • Traditional venous approaches may have limitations in visualizing outflow and treating complex occlusions.
  • Transarterial vascular access interventional therapy (VAIVT) presents an alternative approach.

Observation:

  • The transarterial approach allows direct visualization of venous outflow through the fistula and stump.
  • It facilitates treatment of most strictures and occlusions via a single arterial access point.
  • Both brachial and radial arterial routes are utilized, with the brachial being essential and radial necessary for specific cases.

Findings:

  • VAIVT enables comprehensive assessment and treatment of hemodialysis access issues.
  • The transarterial route is applicable to all VAIVTs, though adjunct venous access may be required for large devices or difficult occlusions.
  • The high origin of the radial artery can be a disadvantage, and local hematomas are the most common complication.

Implications:

  • VAIVT provides a potentially more effective and versatile method for managing failing hemodialysis access.
  • Understanding the advantages and limitations, including potential complications, is crucial for procedural success.
  • This technique may improve outcomes for patients requiring hemodialysis by optimizing access functionality.