By Hans Scholz
This ebook bargains a finished evaluation of updated wisdom on vascular entry surgical procedure. Written via a senior writer with greater than 30 years of expertise and through specialist members, it covers either surgical and theoretical facets. the writer stocks his services in a hands-on process and offers his perspectives at the problems that each clinician may well come across. many of the strategies for vascular entry production are conscientiously reviewed. particular descriptions and various accompanying illustrations of AV fistulas, AV prosthetic grafts, and arterio arterial grafts are supplied, and a bankruptcy can be dedicated to using critical venous catheters. strength issues and their administration are defined, and recommendation is available on how you can take care of detailed sufferer teams requiring additional realization. Separate chapters on fluid dynamics (drawing at the author’s personal study) and vascular pathology cater for the wishes of these with a specific curiosity within the pathophysiological ideas.
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Additional info for Arteriovenous Access Surgery: Ensuring Adequate Vascular Access for Hemodialysis
There are basically two repair options as follows. Aneurysms Aneurysms close to the anastomosis occur frequently. Indications for reconstruction include size, functional limitations, rapid growth, or cosmetics. Reconstruction of the Cephalic Vein in the Cubital Fossa 42 3 AV Fistulas Fig. 78 Proximal feeding via an interposition graft with a long stenosis of the cubital segment Luminal Narrowing by Partial Wall Resection Indication Aneurysmatic segment that is not elongated (Fig. 79). Technical note The aneurysm is exposed via a longitudinal incision over its center from the anastomosis to the normal lumen.
Exposure of the afferent and efferent venous segments. • Resection of the aneurysm with end-to-end anastomosis (Fig. 44). 28 3 AV Fistulas Fig. 45 Long circular exposure of the aneurysmatically-altered vein Prognosis Good long term results. Distinctive feature The fistula runs directly through the scarred area. Partial Resection of the Aneurysm Wall and Closure with Direct Suture Indication/prerequisites AV access worth preserving. Contraindications • Extremely thin skin. • Lack of subcutaneous cover.
Rare Reconstructions Apart from the morphologic and functional alterations of forearm AV fistulas mentioned above, there are numerous other rare alterations. Among these we discuss only one because of its clinical importance: the retrograde arterialization of a forearm cephalic fistula with an anastomosis in the cubital fossa. Possible causes include stenoses or occlusions of the proximal venous runoff after a cephalic AV fistula has been created in the cubital fossa, or its primary retrograde arterialization.
Arteriovenous Access Surgery: Ensuring Adequate Vascular Access for Hemodialysis by Hans Scholz