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Stenosen des Hämodialyse-Shunts

Stenosis of hemodialysis shunts

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Zusammenfassung

Shunt-Stenosen sind spontane, reaktive oder angelegte Strukturelemente vieler Dialyse-Shunts, die abhängig von topographischer Lage und Stenosegrad klinisch als asymptomatisch, behandlungsbedürftig oder protektiv imponieren können. Die jeweilige funktionelle Bewertung entscheidet, ob sie belassen, korrigiert oder angelegt werden.

Abstract

Stenoses of arteriovenous (av) vascular accesses are spontaneous, induced or created structures of many av dialysis fistulas which can be clinically asymptomatic, symptomatic or protective depending on the topographic position and degree of stenosis. The respective quality determines whether a stenosis is left untreated or surgically corrected or created.

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Literatur

  1. Roy-Chaudhury P, Kelly BS, Zhang J et al (2003) Hemodialysis vascular access dysfunction: from pathophysiology to novel therapies. Blood Purif 21:99–110

    Article  PubMed  Google Scholar 

  2. Roy-Chaudhury P, Arend L, Zhang J et al (2007) Neointimal hyperplasia in early arteriovenous fistula failure. Am J Kidney Dis 50:782–790

    Article  PubMed  Google Scholar 

  3. Roy-Chaudhury P, Sukhatme VP, Cheung AK (2006) Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol 17:1112–1127

    Article  PubMed  Google Scholar 

  4. Krönung G (2011) Dialyseshunts Fakten – Fragen – Probleme. Thieme, Stuttgart

  5. Asif A, Leon C, Orozco-Vargas LC et al (2007) Accuracy of physical examination in the detection of arteriovenous fistula stenosis. Clin J Am Soc Nephrol 2:1191–1194

    Article  PubMed  Google Scholar 

  6. Krönung G (2012) Arteriovenöse Shunts als Gefäßzugang. In: Debus ES, Gross-Fengels W (Hrsg) Operative und interventionelle Gefäßmedizin. Springer, Berlin, S 793–814

  7. Mickley V (2004) Stenosis and thrombosis in haemodialysis fistulae and grafts: the surgeon’s point of view. Nephrol Dial Transplant 19:309–311

    Article  PubMed  Google Scholar 

  8. Gadallah MF, Paulson WD, Vickers B, Work J (1998) Accuracy of Doppler ultrasound in diagnosing anatomic stenosis of hemodialysis arteriovenous access as compared with fistulography. Am J Kidney Dis 32:273–277

    Article  PubMed  CAS  Google Scholar 

  9. Shackleton CR, Taylor DC, Buckley AR et al (1987) Predicting failure in polytetrafluoroethylene vascular access grafts for hemodialysis: a pilot study. Can J Surg 30:442–444

    PubMed  CAS  Google Scholar 

  10. Tordoir JH, Bruin HG de, Hoeneveld H et al (1989) Duplex ultrasound scanning in the assessment of arteriovenous fistulas created for hemodialysis access: comparison with digital subtraction angiography. J Vasc Surg 10:122–128

    PubMed  CAS  Google Scholar 

  11. Tordoir JH, Hoeneveld H, Eikelboom BC, Kitslaar PJ (1990) The correlation between clinical and duplex ultrasound parameters and the development of complications in arterio-venous fistulae for haemodialysis. Eur J Vasc Surg 4:179–184

    Article  PubMed  CAS  Google Scholar 

  12. Mac Donald MJ, Martin LG, Hughes JD et al (1996) Distribution and severity of stenoses in functioning arteriovenous grafts: a duplex and angiographic study. J Vasc Technol 20:131–136

    Google Scholar 

  13. Tessitore N, Mansueto G, Bedogna V et al (2003) A prospective controlled trial on effect of percutaneous transluminal angioplasty on functioning arteriovenous fistulae survival. J Am Soc Nephrol 14:1623–1627

    Article  PubMed  Google Scholar 

  14. Beathard GA, Settle SM, Shields MW (1999) Salvage of the nonfunctioning arteriovenous fistula. Am J Kidney Dis 33:910–916

    Article  PubMed  CAS  Google Scholar 

  15. Doelman C, Duijm LE, Liem YS et al (2005) Stenosis detection in failing hemodialysis access fistulas and grafts: comparison of color Doppler ultrasonography, contrast-enhanced magnetic resonance angiography, and digital subtraction angiography. J Vasc Surg 42:739–746

    Article  PubMed  Google Scholar 

  16. Hollenbeck M, Mickley V, Brunkwall J et al (2009) Interdisziplinäre Empfehlung deutscher Fachgesellschaften zum Gefäßzugang zur Hämodialyse. Nephrologe 4:158–176

    Article  Google Scholar 

  17. Schwarz C, Mitterbauer C, Boczula M et al (2003) Flow monitoring: performance characteristics of ultrasound dilution versus color Doppler ultrasound compared with fistulography. Am J Kidney Dis 42:539–545

    Article  PubMed  Google Scholar 

  18. Hollenbeck M, Krumme B (2007) Klinisches und apparatives Monitoring von Dialysefisteln und Prothesenshunts. Nephrologe 2:211–222

    Article  Google Scholar 

  19. Vascular Access 2006 Work Group (2006) Clinical practice guidelines for vascular access. Am J Kidney Dis 48(Suppl 1):S176–S273

    Article  Google Scholar 

  20. Haskal ZJ, Trerotola S, Dolmatch B et al (2010) Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med 362:494–503

    Article  PubMed  CAS  Google Scholar 

  21. Kudlicka J, Kavan J, Tuka V, Malik J (2012) More precise diagnosis of access stenosis: ultrasonography versus angiography. J Vasc Access 13:310–314

    Article  PubMed  Google Scholar 

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Hollenbeck, M., Krönung, G. & Krüger, T. Stenosen des Hämodialyse-Shunts. Nephrologe 8, 175–187 (2013). https://doi.org/10.1007/s11560-013-0746-z

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