TY - JOUR
T1 - Vascular Access for Placement of Tunneled Dialysis Catheters for Hemodialysis
T2 - A Systematic Approach and Clinical Practice Algorithm
AU - Pereira, Keith
AU - Osiason, Adam
AU - Salsamendi, Jason
N1 - Publisher Copyright:
© 2015 Journal of Clinical Imaging Science.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - The role of interventional radiology in the overall management of patients on dialysis continues to expand. In patients with end-stage renal disease (ESRD), the use of tunneled dialysis catheters (TDCs) for hemodialysis has become an integral component of treatment plans. Unfortunately, long-term use of TDCs often leads to infections, acute occlusions, and chronic venous stenosis, depletion of the patient′s conventional access routes, and prevention of their recanalization. In such situations, the progressive loss of venous access sites prompts a systematic approach to alternative sites to maximize patient survival and minimize complications. In this review, we discuss the advantages and disadvantages of each vascular access option. We illustrate the procedures with case histories and images from our own experience at a highly active dialysis and transplant center. We rank each vascular access option and classify them into tiers based on their relative degrees of effectiveness. The conventional approaches are the most preferred, followed by alternative approaches and finally the salvage approaches. It is our intent to have this review serve as a concise and informative reference for physicians managing patients who need vascular access for hemodialysis.
AB - The role of interventional radiology in the overall management of patients on dialysis continues to expand. In patients with end-stage renal disease (ESRD), the use of tunneled dialysis catheters (TDCs) for hemodialysis has become an integral component of treatment plans. Unfortunately, long-term use of TDCs often leads to infections, acute occlusions, and chronic venous stenosis, depletion of the patient′s conventional access routes, and prevention of their recanalization. In such situations, the progressive loss of venous access sites prompts a systematic approach to alternative sites to maximize patient survival and minimize complications. In this review, we discuss the advantages and disadvantages of each vascular access option. We illustrate the procedures with case histories and images from our own experience at a highly active dialysis and transplant center. We rank each vascular access option and classify them into tiers based on their relative degrees of effectiveness. The conventional approaches are the most preferred, followed by alternative approaches and finally the salvage approaches. It is our intent to have this review serve as a concise and informative reference for physicians managing patients who need vascular access for hemodialysis.
KW - End-stage renal disease
KW - hemodialysis
KW - tunneled dialysis catheters
KW - vascular access
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U2 - 10.4103/2156-7514.157858
DO - 10.4103/2156-7514.157858
M3 - Article
AN - SCOPUS:84940842203
VL - 5
JO - Journal of Clinical Imaging Science
JF - Journal of Clinical Imaging Science
SN - 2156-7514
IS - 1
M1 - 31
ER -