Abstract:
Background: The inability of a newly created arteriovenous fistula to support hemodialysis due to non-maturation results in increased complications secondary to catheter dependence. Methods: In view of the highly variable approaches by providers with heterogenous backgrounds (general surgery, vascular surgery, interventional radiology and interventional nephrology, urology, transplant surgery, etc.) we sought to describe a collection of algorithms that have functioned well in our hands to manage this challenging clinical problem and guide trainees and practicing clinicians alike.Results: Physical examination along with selective duplex ultrasound and fistulogram can identify most pathologies underlying non-maturation.Conclusion: Both endovascular and open techniques can be employed to optimize maturation rates in this complex population.
摘要:
背景:由于不成熟,新创建的动静脉瘘无法支持血液透析,导致导管依赖继发的并发症增加。方法:鉴于具有异质背景的提供者的高度可变的方法(普外科,血管手术,介入放射学和介入肾病学,泌尿科,移植手术,等。)我们试图描述一组算法,这些算法在我们手中运作良好,可以管理这个具有挑战性的临床问题,并指导受训者和执业临床医生。结果:体格检查以及选择性双工超声和纤维图可以识别大多数不成熟的病理。结论:血管内和开放技术均可用于优化该复杂人群的成熟率。