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Autologe Gefäßzugänge

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Dialyseshunts

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Zusammenfassung

Für die autologen Gefäßzugänge gibt es mehrere Möglichkeiten, die je nach Patient und Gefäßmuster angelegt werden können. Berücksichtigt werden sollten das Alter, ein Diabetes oder andere Begleiterkrankungen sowie die duplexsonographischen Untersuchungsergebnisse der arteriellen und venösen Gefäße. Das Prinzip, möglichst distal die autologe Fistel anzulegen, sollte nicht dogmatisch angewandt, sondern im Einzelfall des Patienten entschieden werden. Von distal nach proximal können die Tabatiere-, Radialis-, Ulnaris-, Brachialis- oder Basilikafistel, letztere mit sekundärer Vorverlagerung, angewandt werden. Auch ist die Gracz-Fistel eine Alternative. Regelhaft stehen die Seit-zu-Seit- und die Seit-zu-End-Anastomosen zur Verfügung. Nephrologen und Shuntchirurgen sollten gemeinsam den Patienten auf die Operation vorbereiten, wobei das duplexonographische Gefäßmapping am ehesten vom operierenden Shuntchirurgen durchgeführt wird. Schwierigkeiten bei der Shuntpunktion sind häufig Folge eines zu geringen Blutflusses und führen nach Ausschluss anderer Ursachen zu einer operativen Revision

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Author information

Authors and Affiliations

  1. Universitätsklinikum Köln, Klinik und Poliklinik für Gefäßchirurgie, Kerpener Str. 62, 50937, Köln, Deutschland

    V. Matoussevitch

  2. Moitzfeld 42, 51429, Bergisch-Gladbach, Deutschland

    P. Konner

  3. Schau Ins Land 24, 51429, Bergisch Gladbach, Deutschland

    K. Konner

  4. Universitätsklinikum Ulm, Klinik für Innere Medizin I, Nephrologie, Albert-Einstein-Allee 23, 89070, Ulm, Deutschland

    F. Keller

  5. Universitätsklinikum Ulm, Klinik für Innere Medizin I, Nephrologie, Albert-Einstein-Allee 23, 89070, Ulm, Deutschland

    U. Ludwig

  6. Plehmpfad 70a, 12557, Berlin, Deutschland

    C. Cetto

  7. Marien-Hospital Witten, Klinik für Gefäßchirurgie, Marienplatz 2, 58452, Witten, Deutschland

    S. Langer

  8. Haaner Str. 114, 42719, Solingen, Deutschland

    W. Hepp

  9. St. Joseph Krankenhaus, Zentrum für Dialysezugänge, Wüsthoffstr. 15, 12101, Berlin Tempelhof, Deutschland

    E. U. Metzler

Authors
  1. V. Matoussevitch
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  2. P. Konner
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  3. K. Konner
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  4. F. Keller
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  5. U. Ludwig
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  6. C. Cetto
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  7. S. Langer
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  8. W. Hepp
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  9. E. U. Metzler
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Correspondence to V. Matoussevitch .

Editor information

Editors and Affiliations

  1. Solingen, Germany

    Wolfgang Hepp

  2. Nephrologisches Zentrum Mettmann , Mettmann, Nordrhein-Westfalen, Germany

    Michael Koch

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Matoussevitch, V. et al. (2017). Autologe Gefäßzugänge. In: Hepp, W., Koch, M. (eds) Dialyseshunts. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-52699-6_4

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  • DOI: https://doi.org/10.1007/978-3-662-52699-6_4

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