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International Urology and Nephrology

, Volume 48, Issue 9, pp 1469–1475 | Cite as

The importance of success prediction in angioaccess surgery

  • Branko FilaEmail author
  • Saša Magaš
  • Predrag Pavić
  • Renata Ivanac
  • Marko Ajduk
  • Marko Malovrh
Nephrology – Review

Abstract

Access to the circulation is an “Achilles’ heel” of chronic hemodialysis. According to the current guidelines, autologous arteriovenous fistula is the best choice available. However, the impossibility of immediate use and the high rate of non-matured fistulas place fistula far from an ideal hemodialysis vascular access. The first attempt at constructing an angioaccess should result in functional access as much as possible. After failed attempts, patients and nephrologists lose their patience and confidence, which results in high percentage of central venous catheter use. Predictive models could help, but clinical judgment still remains crucial. Early referral to the nephrologist and vascular access surgeon, careful preoperative examinations, preparation of patients and duplex sonography mapping of the vessels are very important in the preoperative stage. In the operative stage, it is crucial to understand that angioaccess procedures should not be considered as minor procedures and these operations must be performed by surgeons with demonstrable interest and experience. In the postoperative stage, appropriate surveillance of the maturation process is also important, as well as good cannulation skills of the dialysis staff. The purpose of this review article is to stress the importance of success prediction in order to avoid unsuccessful attempts in angioaccess surgery.

Keywords

Hemodialysis Vascular access Success prediction 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Branko Fila
    • 1
    Email author
  • Saša Magaš
    • 2
  • Predrag Pavić
    • 3
  • Renata Ivanac
    • 4
  • Marko Ajduk
    • 1
  • Marko Malovrh
    • 5
  1. 1.Department of Vascular SurgeryUniversity Hospital DubravaZagrebCroatia
  2. 2.University Clinic for Diabetes, Endocrinology and Metabolism Vuk VrhovacClinical Hospital „Merkur“ZagrebCroatia
  3. 3.Department of Vascular SurgeryClinical Hospital „Merkur“ZagrebCroatia
  4. 4.Dialysis DepartmentGeneral Hospital BjelovarBjelovarCroatia
  5. 5.Department of NephrologyUniversity Medical Centre LjubljanaLjubljanaSlovenia

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