Management of patients with challenging vascular access needs.

Abstract:

:The proportion of patients on dialysis with multiple access procedures, failed transplant(s), or no suitable sites for conventional arteriovenous (AV) fistula is increasing. We report on 4 patients at our institution requiring unusual measures to achieve vascular access for dialysis. All 4 patients had temporary femoral vein catheters for dialysis, but 3 had tunneled femoral catheters, with 1 patient using this modality of access for 28 months. One patient who had 13 vascular access procedures developed collateral circulation that was amenable to a new autogenous AV fistula. Two patients died of causes unrelated to vascular access, whereas 1 died from infection of an access device. In patients with challenging vascular access requirements, the use of simple procedures such as the insertion of a tunneled femoral catheter should be considered. A thorough assessment must be made before each new access procedure as collateral circulation may present new options.

journal_name

Int Surg

journal_title

International surgery

authors

Akoh JA,Riaz M

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

95-8

issue

2

eissn

0020-8868

issn

2520-2456

journal_volume

94

pub_type

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