Maintaining a functioning vascular access in hemodialysis patient remains an important and difficult problem. The gold standard in these patients is the autologous arteriovenous fistula (AVF). Sometimes the situation is different and complicated. In this case one must resort to the heterologous prosthetic implants, of which the PTFE (polytetrafluoroethylene) is the most used and recommended by the National Kydney Foundation (NKF) in clinical practice guide (DOQI). The number of patients requiring hemodialysis HD for a long time is increasing, there for we recommend these accesses...

The Vascular Interventional Radiology Unit of Reina Sofia Hospital, in Murcia, Spain, is one of the principal unit for hemodialysis vascular access in our region. It covers three secondary hospitals, with their corresponding hemodialysis units, and 7 peripheral dialysis centers. We performed a retrospective study from January 2005 to December 2012. We analyzed all cases with femoro-femoral PTFE prosthetic implants. Of all patients analyzed, only 8 femoro-femoral PTFE prosthetic implants were found, (3 in the right lower limb and 5 in the left lower limb)...

Of all angioplasties performed, 19 were prophylactic, with a mean time interval between them of about 2.2 months. Of 27 angioplasties performed, there were no immediate complications, getting a good post angioplasty flow in 100% of cases, objectified by physical examination and ReoCath catheter's flow measurement. (Fig. 14 )The most common lesion was dilated venous anastomosis (#10).Table 1 We had no immediate complications during thrombectomy resulting in permeability and good flows immediately post interventional. In 24 cases the flow was measured with ReoCath catheter, showing...

- Performing femoro-femoral PTFE prosthetic implants is a very good intervention of patients exhausted of all vascular access sites in both upper extremities and central venous injuries that made it impossible to place a central venous catheter. - The femoro-femoral PTFE prosthetic implantsof vascular interventional radiology follow-up and monitoring suppose a permeability's time prolongation. We have to performe a periodic evaluation of the function and correction of detected faults - Our results clearly demonstrate the importance of an active attitude to these patients and the...

García Medina J, Lacasa Pérez N, Muray Cases S, Pérez Garrido I, García Medina V. Thrombosis in vascular accesses for haemodialysis: rescue treatment using invasive vascular radiological techniques]. Nefrologia. 2009;29(3):249-55. Cerri J, Ramacciotti E, Gomes M, Tedeschi Filho W, Piccinato CE. Latero-lateral femoro-femoral arteriovenous fistula: a new surgical approach for hemodialysis patients with no vascular access. Acta Cir Bras. 2011 Feb;26(1):72-6