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Essentials of Percutaneous Dialysis Interventions pp 357–378Cite as

Central Venous Interventions

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Abstract

Central venous stenosis (CVS) and occlusions in the hemodialysis patient are unique clinical problems that arise mainly from previous central venous catheter insertions, particularly from the subclavian vein approach and left-sided approaches [1–4]. As a result of this observation, K/DOQI recommends placement of more permanent venous access and avoiding catheter-based dialysis when possible [5]. Insertion of pacemaker wires, central venous ports, and peripherally inserted central catheters (PICC) also contribute to an increased incidence of central venous lesions. This is perhaps one of the most significant problems to be addressed in the near future for dialysis patients as they live longer from advances in medical therapy and interventions. Despite consensus guidelines such as K/DOQI and widespread use of venous mapping, most patients present or declare themselves as having a significant central venous stenosis after an access is placed on the side of the lesion.

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Author information

Authors and Affiliations

  1. Division of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada

    Dheeraj K. Rajan MD, FRCPC, FSIR (Head and Associate Professor)

  2. Interventional Radiology, Department of Radiology, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA

    Timothy I. Clark MD, FSIR (Associate Professor of Radiology, Director)

  3. Mid Peninsula Wound Care Medical Clinic, Peninsula Surgical Specialists Medical Group, Burlingame, CA, 94010, USA

    Dirk S. Baumann MD, FACS (Director)

Authors
  1. Dheeraj K. Rajan MD, FRCPC, FSIR
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  2. Timothy I. Clark MD, FSIR
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  3. Dirk S. Baumann MD, FACS
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Corresponding author

Correspondence to Dheeraj K. Rajan MD, FRCPC, FSIR .

Editor information

Editors and Affiliations

  1. Radiology - Dept. of Medical Imaging, University of Toronto, Division of Vascular and Interventional, University Ave. 585, Toronto, M5G 2N2, Ontario, Canada

    Dheeraj Rajan

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Rajan, D.K., Clark, T.I., Baumann, D.S. (2011). Central Venous Interventions. In: Rajan, D. (eds) Essentials of Percutaneous Dialysis Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5657-6_20

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  • DOI: https://doi.org/10.1007/978-1-4419-5657-6_20

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  • Online ISBN: 978-1-4419-5657-6

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