Öz
Stenosis is the most frequent problem causing an access dysfunction. We know that tight stenosis is the underlying reason for acute thrombosis in vast majority of the cases. Since the morbidity and mortality of these patients are directly related to the effectiveness of hemodialysis, treatment of the stenosis is of great importance.Dilatation with percutaneous transluminal angioplasty is performed with catheters containing inflatable balloons of 3-16 mm in diameter and 2-16 cm in length for vessels of different sizes.Pharmacological methods or mechanical methods or both can be used for the recanalization of thrombosed fistulas. Pharmacological methods use local infusion of thrombolytics.Conventional graft surgery has been shown to be more effective and lasting more than the endovascular approach.Immature fistulas are minimally invasive and endovascular intervention is generally preferred because the venous reserve is preserved.Surgery and interventional radiology cooperation and correct intervention at the right time are crucial in prolonging the life span of hemodialysis patients
Anahtar Kelimeler
Percutaneous transluminal angioplasty stent thrombectomy vascular intervention thrombosis
Kaynakça
- Turmel-Rodrigues L, Pengloan J, Bourquelot P. Interventional radiology in hemodialysis fistulae and grafts: a multidisciplinary approach. Cardiovasc Intervent Radiol 2002; 25: 3–16. [CrossRef]
- Turmel-Rodrigues L, Bourquelot P, Raynaud A, Sapoval M. Primary stent placement in hemodialysis-related central venous stenoses: the dangers of a potential ‘radiologic dictatorship’. Radiology 2000;217: 600–2. [CrossRef]
- Raynaud AC, Angel CY, Sapoval MR, Beyssen B, Pagny JY, Auguste M. Treatment of hemodialysis access rupture during PTA with Wallstent implantation. J Vasc Interv Radiol 1998; 9: 437–42.
- Turmel-Rodrigues L, Sapoval M, Pengloan J et al. Manual thromboaspiration and dilation of thrombosed dialysis access: mid- term results of a simple concept. J Vasc Interv Radiol 1997; 8: 813–24.
- Valji K, Bookstein JJ, Roberts AC, Oglevie SB, Pittman C, O’Neil MP. Pulse-spray pharmacomechanical thrombolysis of thrombosed hemodialysis access grafts: long-term experience and comparison of the original and current techniques. Am J Radiol 1995;164:1495– 500. [CrossRef]
- Turmel-Rodrigues L, Pengloan J, Baudin S, Testou D, Abaza M, Dahdah G, et al. Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology. Nephrol Dial Transplant 2000; 15: 2029–36. [CrossRef]
- Turmel-Rodrigues L, Pengloan J, Rodrigue H, Brillet G, Lataste A, Pierre D, et al. Treatment of failed native arteriovenous fistulae for hemodialysis by interventional radiology. Kidney Int 2000; 57: 1124– 40. [CrossRef]
- Turmel-Rodrigues L, Mouton A, Birmelé B, Billaux L, Ammar N, Grézard O, Hauss S, Pengloan J, et al. Salvage of immature forearm fistulas for haemodialysis by interventional radiology. Nephrol Dial Transplant 2001; 16: 2365–71. [CrossRef]
- Hingorani A, Ascher E, Kallakuri S, Greenberg S, Khanimov Y. Impact of reintervention for failing upper-extremity arteriovenous autogenous access for hemodialysis. J Vasc Surg 2001; 34: 1004–9. [CrossRef]
- Berman SS, Gentile AT. Impact of secondary procedures in autogenous arteriovenous fistula maturation and maintenance. J Vasc Surg 2001;34: 866–71. [CrossRef]
Öz
Fistül disfonksiyonunun en sık nedeni stenozlardır. Stenozlar, akut tromboza neden olarak fistülün durmasına neden olabilir. Diyaliz hastalarının mortalite ve morbiditesi hemodiyaliz kalitesi ile direk ilişkilidir bu nedenle AV fistüllerdeki stenozların tedavisi oldukça önemlidir.Günümüzde; stenoz ve trombozlar ; stent yerleştirilmesi veya balon dilatasyon ve bir çok pıhtı çözücü teknikleri içeren girişimsel radyoloji teknikleri ile tedavi edilebilir .Perkutan transluminal anjioplasti ile dilatasyon farklı boyutlardaki damarlar için 3-16mm çapta ve 2-16cm uzunlukta, şişirilebilen balonlar içeren kataterlerle uygulanır. Tromboze fistüllerin rekanalizasyonu için farmakolojik veya mekanik yöntemler veya her iki yöntem birlikte kullanılabilir. Farmakolojik yöntemlerde trombolitiklerin lokal infüzyonu kullanılır.Greftlerde konvansiyonel cerrahinin endovasküler yaklaşımdan biraz daha etkili ve kalıcı olduğu gösterilmiştir.Immatur fistüllerde ise minimal invaziv olduğu ve venöz rezerv korunduğu için genellikle endovasküler girişim tercih edilmektedir.Cerrahi ve girişimsel radyoloji işbirliği ve doğru zamanda, doğru şekilde müdahale edilmesi AV yolla hemodiyalize giren hastaların yaşam sürelerinin uzatılmasında son derece önemlidir
Anahtar Kelimeler
Perkutan transluminal anjyoplasti stent trombektomi vasküler girişim tromboz
Kaynakça
- Turmel-Rodrigues L, Pengloan J, Bourquelot P. Interventional radiology in hemodialysis fistulae and grafts: a multidisciplinary approach. Cardiovasc Intervent Radiol 2002; 25: 3–16. [CrossRef]
- Turmel-Rodrigues L, Bourquelot P, Raynaud A, Sapoval M. Primary stent placement in hemodialysis-related central venous stenoses: the dangers of a potential ‘radiologic dictatorship’. Radiology 2000;217: 600–2. [CrossRef]
- Raynaud AC, Angel CY, Sapoval MR, Beyssen B, Pagny JY, Auguste M. Treatment of hemodialysis access rupture during PTA with Wallstent implantation. J Vasc Interv Radiol 1998; 9: 437–42.
- Turmel-Rodrigues L, Sapoval M, Pengloan J et al. Manual thromboaspiration and dilation of thrombosed dialysis access: mid- term results of a simple concept. J Vasc Interv Radiol 1997; 8: 813–24.
- Valji K, Bookstein JJ, Roberts AC, Oglevie SB, Pittman C, O’Neil MP. Pulse-spray pharmacomechanical thrombolysis of thrombosed hemodialysis access grafts: long-term experience and comparison of the original and current techniques. Am J Radiol 1995;164:1495– 500. [CrossRef]
- Turmel-Rodrigues L, Pengloan J, Baudin S, Testou D, Abaza M, Dahdah G, et al. Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology. Nephrol Dial Transplant 2000; 15: 2029–36. [CrossRef]
- Turmel-Rodrigues L, Pengloan J, Rodrigue H, Brillet G, Lataste A, Pierre D, et al. Treatment of failed native arteriovenous fistulae for hemodialysis by interventional radiology. Kidney Int 2000; 57: 1124– 40. [CrossRef]
- Turmel-Rodrigues L, Mouton A, Birmelé B, Billaux L, Ammar N, Grézard O, Hauss S, Pengloan J, et al. Salvage of immature forearm fistulas for haemodialysis by interventional radiology. Nephrol Dial Transplant 2001; 16: 2365–71. [CrossRef]
- Hingorani A, Ascher E, Kallakuri S, Greenberg S, Khanimov Y. Impact of reintervention for failing upper-extremity arteriovenous autogenous access for hemodialysis. J Vasc Surg 2001; 34: 1004–9. [CrossRef]
- Berman SS, Gentile AT. Impact of secondary procedures in autogenous arteriovenous fistula maturation and maintenance. J Vasc Surg 2001;34: 866–71. [CrossRef]
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019Sayı: 3 |