Substitution of a Percutaneous Vascular Access for Repeated Hemodialysis in Children
If standard arteriovenous vascular access is not available, alternatives must be created when hemodialysis is indicated. Most often the need is transient as in acute renal failure, or in chronic renal failure when a more permanent access has not yet matured. However, in an occasional patient all potential sites for permanent vascular access have become irreversibly occluded. In both acute and chronic failure, it may be of utmost importance to the child’s subsequent management to preserve as many peripheral vessel sites as possible for future fistula or shunt creation. A flexible catheter, percutaneously placed into an alternative vascular site, with sufficient caliber for adequate blood flow, and of variable length to accomodate to the child’s size would be of considerable value in these situations. Such a catheter has been developed for pediatrics in our unit with experience over a 22 month period in 21 children.
KeywordsAcute Renal Failure Chronic Renal Failure Guide Wire Vascular Access Subclavian Vein
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