To show the advantages of clinical-surgical-radiological correlation of discrepant hemodialysis access mapping
To illustrate radiological challenges in mapping and follow-up of hemodialysis access
Vascular access is the mainstream in dialysis patients.
is known that complications after vascular access construction are associated to increased morbidity and mortality.1,2
There are two main types of vascular access: native arteriovenous fistula and arteriovenous graft.
Arteriovenous fistula is the favorite access for hemodialysis.
The goal is to create a long-standing functional vascular pathway.
multidisciplinary approach is crucial to increase the lifetime of the vascular access.3,4 Fig. 1
it is very important for the radiologist to know that there is countless...
Findings and procedure details
The authors gathered imaging findings of hemodialysis access challenges in mapping and follow-up.
Patients were studied with Eco-Doppler,
contrast-enhanced CT (dialysis patientes) ans MR without gadolinium (chronic renal disease).
PREOPERATIVE EVALUATION - CHECKPOINTS
Complete clinical history (including the cause of the renal failure),
is important to determine the urgency of which access is needed to be constructed.
It is also important to know if patient was submitted to previous endovascular therapeutic procedures and evaluate the patency of vessels.
Recognizing the presence of atherosclerosis will...
Adequate multidisciplinary approach of vascular mapping before surgery and correct follow-up are crucial to preserve hemodialysis access.
Vascular variants or procedure complications should be recognized in order to quickly take decisions,
avoiding vascular depletion.
1st author: Catarina Ala Baraças
Radiology Resident in Pedro Hispano Hospital,
Mortality and hospitalization in haemodialysis patients in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).
Nephrol Dial Transplant.
Vascular access and all-cause mortality: a propensity score analysis.
J Am Soc Nephrol.
Interventional radiology in hemodialysis fistulae and grafts: a multidisciplinary approach.
Cardiovasc Intervent Radiol.
4.Besarab A JK,