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[Emergency and temporary vascular access]

G Paternoster1, A Molino, S Alloatti

  • 1Servizio di Nefrologia e Dialisi, Ospedale Regionale, Aosta.

Minerva Urologica E Nefrologica = the Italian Journal of Urology and Nephrology
|May 14, 1998
PubMed
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Vascular access is crucial for hemodialysis. Jugular vein catheterization is preferred over subclavian due to fewer complications, though arteriovenous fistulas remain ideal when feasible.

Area of Science:

  • Nephrology
  • Vascular Surgery

Background:

  • Vascular access is essential for extracorporeal therapies like hemodialysis.
  • Historically, external shunts were common, but vena cava catheterization increased due to ease and technological advancements.

Purpose of the Study:

  • To review current practices and complications associated with emergency vascular access for hemodialysis.
  • To compare the efficacy and safety of different vascular access routes.

Main Methods:

  • Review of literature on vascular access techniques for hemodialysis.
  • Analysis of complication rates and patient outcomes for femoral, subclavian, and jugular venous access.

Main Results:

  • Femoral access is used in 30% of cases, particularly in critically ill patients, due to ease and low complication rates.

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  • Subclavian vein access is largely abandoned in favor of jugular vein access due to higher rates of early complications and thrombo-stenotic lesions (50%).

    • Conclusions:

    • Effective prevention and management of complications are key to prolonged catheter survival.
    • While arteriovenous fistulas are ideal, jugular vein access is justified for specific patient groups requiring permanent access.