Duplex Examination of the Hemodialysis Access

Jul 25, 2017 by in NEPHROLOGY Comments Off on Duplex Examination of the Hemodialysis Access

Failure of autogenous vein maturation Thrombosis Inadequate arterial inflow Impaired venous outflow Infection Hematoma, seroma, lymphocele Pseudoaneurysms Arterial steal (hand ischemia) Venous hypertension (limb swelling) High-output cardiac failure Duplex Ultrasound…

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Current Hemodialysis Techniques

Jul 25, 2017 by in NEPHROLOGY Comments Off on Current Hemodialysis Techniques

Fig. 19.1 Needle gauge size for a hemodialysis treatment range from 17-gauge needles for slower blood flow rates (250 mL/min) and initiating dialysis with a new arteriovenous fistula, up to…

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Hemodialysis Grafts

Jul 25, 2017 by in NEPHROLOGY Comments Off on Hemodialysis Grafts

(1) Department of Surgery, Division of Vascular Surgery, Duke University Medical Center, Durham, NC 27710, USA (2) Humacyte Incorporated, Research Triangle Park, NC 27709, USA (3) Department of Surgery, Duke University Medical…

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Preoperative Considerations and Imaging

Jul 25, 2017 by in NEPHROLOGY Comments Off on Preoperative Considerations and Imaging

History assessment Relevance Dominant arm Use of nondominant arm is preferred to minimize negative impact on quality of life History of previous central venous catheter Associated with central venous stenosis…

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The Hemodialysis Reliable Outflow (HeRO) Graft

Jul 25, 2017 by in NEPHROLOGY Comments Off on The Hemodialysis Reliable Outflow (HeRO) Graft

Fig. 32.1 Forearm Scribner shunt, VA Hospital, Bronx, NY 1964 (Courtesy of Dr. Lawson) Fig. 32.2 Early Graftcath device. Note: Venous outflow component without nitinol reinforcement (generation 2) (Used with…

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The Thrombosed Hemodialysis Access

Jul 25, 2017 by in NEPHROLOGY Comments Off on The Thrombosed Hemodialysis Access

Fig. 35.1 Intimal hyperplasia at the distal anastomosis of a prosthetic graft (left) to a vein (right) Causes of Access Failure Thrombosis of arteriovenous access is related to the same…

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Arterial Inflow Stenosis

Jul 25, 2017 by in NEPHROLOGY Comments Off on Arterial Inflow Stenosis

Fig. 29.1 (a) Doppler US shows the presence of a stenosis of the brachial artery in a patient with a poorly functioning fistula. (b) Gray-scale US of the anastomosis shows…

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Forearm Vein Transposition

Jul 25, 2017 by in NEPHROLOGY Comments Off on Forearm Vein Transposition

Fig. 16.1 Incision sites overlying forearm cephalic vein for transposition Fig. 16.2 Dilation of dissected forearm cephalic vein with heparinized saline The portion of the radial artery that has been…

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Peritoneal Dialysis

Jul 25, 2017 by in NEPHROLOGY Comments Off on Peritoneal Dialysis

Fig. 40.1 Laparoscopic revision of a “trapped” catheter Once the patient has been determined to be a good candidate for peritoneal dialysis through the evaluation of their ability to perform…

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Hemodialysis Access Catheters

Jul 25, 2017 by in NEPHROLOGY Comments Off on Hemodialysis Access Catheters

Fig. 13.1 A tunneled internal jugular hemodialysis catheter. (a) Right internal jugular hemodialysis catheter. Note the smooth transition of the catheter as it courses over the right clavicle without kinking….

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