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Complications in blood access for hemodialysis
1Department of Surgery, Tokyo Women's Medical College, Japan.
Artificial Organs
|April 1, 1994
Summary
Complications from hemodialysis blood access, particularly arteriovenous fistula (AVF) dysfunction and thrombosis, are frequent. Surgical reconstruction and graft management are key to successful treatment and maintaining vascular access.
Area of Science:
- Nephrology
- Vascular Surgery
- Medical Device Technology
Background:
- Vascular access is critical for hemodialysis.
- Complications can significantly impact patient outcomes and treatment continuity.
- Arteriovenous fistulas (AVFs) and grafts are common access methods.
Purpose of the Study:
- To analyze the types and frequencies of blood access complications.
- To evaluate the effectiveness of surgical interventions for these complications.
- To identify risk factors and outcomes associated with access-related issues.
Main Methods:
- Retrospective analysis of 580 blood access complications.
- Data collected from January 1991 to December 1992.
- Review of patient treatments, including AVF reconstruction and prosthetic graft usage.
Main Results:
- Dysfunction and thrombosis of AVFs were the most common complications (77.8%).
- Prosthetic grafts showed 1-year patency rates of 74.6% (ePTFE) and 64.2% (polyurethane).
- Infections occurred in 20 patients, with successful treatment via resection and rerouting in 6 cases.
Conclusions:
- Hemodialysis access procedures have significant complication rates.
- Surgical expertise in both creation and complication management is essential.
- Timely and appropriate surgical intervention can lead to successful outcomes.