Monitoring the Patient Following Radio-Cephalic Arteriovenous Fistula Creation: Current Perspectives.
Arteriovenous Shunt, Surgical
/ adverse effects
Early Diagnosis
Graft Occlusion, Vascular
/ diagnosis
Humans
Physical Examination
Predictive Value of Tests
Radial Artery
/ diagnostic imaging
Renal Dialysis
Risk Factors
Time Factors
Treatment Failure
Ultrasonography, Doppler, Duplex
Vascular Patency
Veins
/ diagnostic imaging
Wrist
/ blood supply
arteriovenous fistula maturation
early failure
hemodialysis
rule of six
vascular access
Journal
Vascular health and risk management
ISSN: 1178-2048
Titre abrégé: Vasc Health Risk Manag
Pays: New Zealand
ID NLM: 101273479
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
02
2021
accepted:
19
03
2021
entrez:
15
4
2021
pubmed:
16
4
2021
medline:
30
4
2021
Statut:
epublish
Résumé
Autogenous radial-cephalic direct wrist arteriovenous fistula (RC-AVF) in the non-dominant arm is the gold standard for dialysis vascular access. However, the RC-AVF non-maturation rate is significant (≃ 40%) due to an increasingly elderly and comorbid population incidence. A detailed identification of the biological cascade underlying arteriovenous fistula (AVF) maturation could be the key to clinical research aimed at identify the group of patients at risk of primary AVF failure. Currently, careful post-operative monitoring remains the most crucial aspect to overcome the problem of impaired maturation. Up to 80% of patients with immature RC-AVF have problems potentially solvable with early endovascular or surgical correction. Physical examination by experienced practitioners in conjunction with duplex ultrasound examination (DUS) can identify physical signs of non-maturation, understand the underlying cause, and drive for a tailored early planning to treat the complication. New approaches for the early assessment of AVF maturation are under study. Techniques to promote RC-AVF maturation performed through the administration of pre-or peri-operative drugs have missed up to now to prove an efficacy in improving fistula success. The new techniques tested after surgery appear to hold future promise for improving fistula maturation.
Identifiants
pubmed: 33854321
doi: 10.2147/VHRM.S205130
pii: 205130
pmc: PMC8040072
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
111-121Informations de copyright
© 2021 Pirozzi et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
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