Related Experiment Video
Updated: Jun 5, 2025
08:39
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
1.6K
Management of thrombosed or failed dialysis access
Stephen N Dalton-Petillo1, Jeffrey J Siracuse1
1Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, Boston Medical Center, 88 East Newton Street, Boston, MA 02118.
Seminars in Vascular Surgery
|December 15, 2024
Summary
Maintaining hemodialysis (HD) access patency is crucial for end-stage renal disease patients. This review covers fistula failure causes, diagnosis, and treatments like angioplasty and thrombectomy to restore flow.
Area of Science:
- Nephrology
- Vascular Surgery
- Interventional Radiology
Background:
- End-stage renal disease (ESRD) necessitates hemodialysis (HD) access.
- Maintaining fistula patency is challenging due to stenosis and thrombosis.
- ESRD, altered hemodynamics, and comorbidities exacerbate access failure.
Purpose of the Study:
- To review the pathophysiology of common hemodialysis fistula failures.
- To outline diagnostic methods for fistula dysfunction.
- To discuss endovascular and surgical treatment options for flow restoration.
Main Methods:
- Review of pathophysiology of fistula failure.
- Compilation of diagnostic techniques including clinical assessment and imaging.
- Summary of endovascular and surgical management strategies.
Main Results:
- Fistula failure primarily results from inflow/outflow stenosis or thrombosis.
- Diagnosis involves a multimodal approach: history, exam, HD measurements, labs, and imaging.
- Treatment options include angioplasty, stenting, thrombectomy, and open surgery.
Conclusions:
- Understanding fistula failure pathophysiology is key for effective management.
- Timely diagnosis and appropriate intervention are vital for preserving HD access.
- Both endovascular and surgical techniques offer viable options for restoring fistula patency.
Related Concept Videos
01:27Dialysis
261
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
261
01:28Esophageal Varices-II: Clinical Features and Management
46
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
46