Stenosis in hemodialysis arteriovenous fistula: Evaluation and treatment

Tipo
Artigo
Data de publicação
2006
Periódico
Hemodialysis International
Citações (Scopus)
44
Autores
Campos R.P.
Do Nascimento M.M.
Chula D.C.
Do Nascimento D.E.
Riella M.C.
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Título de Volume
Membros da banca
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Resumo
Vascular access complications are one of the main causes associated with an increase in morbidity and mortality in stage 5 chronic kidney disease patients. The arteriovenous fistula is regarded as the vascular access of choice for hemodialysis (HD) because of its superior patency and lower complication rates. Stenosis is considered the major cause of dysfunction of arteriovenous fistula. Despite the relatively low thrombosis rates of arteriovenous fistula, surveillance programs are necessary for detection of stenosis. We report a case of a HD patient who had never achieved an adequate Kt/V since the start of maintenance HD. During the investigation, abnormal findings were found on physical examination of the fistula, in addition to an alteration in intra-access pressure (IAP) measurements. A venous stenosis was diagnosed by Doppler ultrasound and then promptly treated with percutaneous transluminal angioplasty. The purpose of the discussion is to highlight the peculiarities of arteriovenous fistulae, methods of surveillance, including physical examination, IAP, recirculation, and measurements of blood flow, and the importance of the correction procedures for the stenosis. © 2006 International Society for Hemodialysis.
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