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.
Literatur
Roy-Chaudhury P, Kelly BS, Zhang J et al (2003) Hemodialysis vascular access dysfunction: from pathophysiology to novel therapies. Blood Purif 21:99–110
Roy-Chaudhury P, Arend L, Zhang J et al (2007) Neointimal hyperplasia in early arteriovenous fistula failure. Am J Kidney Dis 50:782–790
Roy-Chaudhury P, Sukhatme VP, Cheung AK (2006) Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol 17:1112–1127
Krönung G (2011) Dialyseshunts Fakten – Fragen – Probleme. Thieme, Stuttgart
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
Krönung G (2012) Arteriovenöse Shunts als Gefäßzugang. In: Debus ES, Gross-Fengels W (Hrsg) Operative und interventionelle Gefäßmedizin. Springer, Berlin, S 793–814
Mickley V (2004) Stenosis and thrombosis in haemodialysis fistulae and grafts: the surgeon’s point of view. Nephrol Dial Transplant 19:309–311
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
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
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
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
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
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
Beathard GA, Settle SM, Shields MW (1999) Salvage of the nonfunctioning arteriovenous fistula. Am J Kidney Dis 33:910–916
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
Hollenbeck M, Mickley V, Brunkwall J et al (2009) Interdisziplinäre Empfehlung deutscher Fachgesellschaften zum Gefäßzugang zur Hämodialyse. Nephrologe 4:158–176
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
Hollenbeck M, Krumme B (2007) Klinisches und apparatives Monitoring von Dialysefisteln und Prothesenshunts. Nephrologe 2:211–222
Vascular Access 2006 Work Group (2006) Clinical practice guidelines for vascular access. Am J Kidney Dis 48(Suppl 1):S176–S273
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
Kudlicka J, Kavan J, Tuka V, Malik J (2012) More precise diagnosis of access stenosis: ultrasonography versus angiography. J Vasc Access 13:310–314
Interessenkonflikt
Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hollenbeck, M., Krönung, G. & Krüger, T. Stenosen des Hämodialyse-Shunts. Nephrologe 8, 175–187 (2013). https://doi.org/10.1007/s11560-013-0746-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11560-013-0746-z
Schlüsselwörter
- Gefäßzugang
- Arteriovenöser Shunt
- “High-output failure”
- Shunt-assoziiertes Steal-Syndrom
- Venöses Stauungssyndrom