Learning objectives
- Identify in the preoperative the adequate arterial and venous vessels that allow to obtain a vascular access with high success rate.
- Recognize the functional criteria of arteriovenous fistulas,
as well as failure criteria.
- Identify the complications associated with arteriovenous fistulas.
Background
An arteriovenous fistula (AVF) for hemodialysis is a communication generated surgically between a vein and an artery.
Frequently they're performed on the upper limbs,
although when they fail,
they can sometimes be seen in the lower limbs.
Surgeons try to make it as distal as possible in the non-dominant arm.
By this way,
the proximal vessels are preserved for future access.
Arteriovenous fistulas (AVF) are the method of choice for vascular access for patients in renal replacement therapy.
A permeablevascular access is the key to...
Findings and procedure details
An adequate preoperative evaluation of the patient,
and knowledge of the good prognosis criteria of fistulas,
allow the optimal choice of arteries and veins,
that will be part of the fistula and that will lead to successful access.
Likewise,
the postoperative evaluation that allows to identify the maturity of the arteriovenous fistulas and the associated complications result in an appropriate and functional vascular access over time.
The first choice access is autologous arteriovenous fistula because of its better functioning and long-term duration.
Autologous fistulas have...
Conclusion
Vascular access is of vital importance in the treatment of renal replacement,
both for being able to condition the quality of dialysis and for deriving from it a high morbidity and costs.
The use of Color Doppler ultrasound allows not only the monitoring of the flow,
but also the immediate diagnosis of pathology and its level of therapeutic urgency.
It's the first technique per image,
with a relevant role in the diagnosis and monitoring of these patients,
being a non-invasive test and without delays in...
Personal information
Dr.AbramzonFernando.
ChiefofDepartamentofRadiology,HospitaldetraumaDrFedericoAbete.
Malvinas Argentinas,BuenosAires.Argentina
Email:
[email protected]
Dra.Crosta Julieta
Chiefofultrasound,HospitaldetraumaDrFedericoAbete.
MalvinasArgentinas,Buenos Aires.Argentina
Email:
[email protected]
DepartamentofRadiology,HospitaldetraumaDrFedericoAbete.
Chief resident.
Dra.
Narvaez Yuly.
Residetintraining.
Dr.
Averanga Gustavo
Dra.LealGrettel.
Dr.
Palacios Leyder.
References
1.
Arteriovenous fistulas for hemodialysis
Nephrology a day.
2012; 7: 010.3265 / Nefrologia.2010.pub1.ed80.chapter2813.
2.Ecography of vascular access for hemodialysis: theoretical,
practical concepts and criteria.
DOI: 10.3265 / NefrologiaSuplementoExtraordinario.pre2012.Dec.11877
3.
What should not be missing in the evaluation of arteriovenous fistulas for hemodialysis.
Annals of Radiology Mexico 2007; 3: 247-250.