Hemodialysis Vascular Access: Practice and problems

Hardcover | February 24, 2000

EditorPeter Conlon, Michael Nicholson, Steve Schwab

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This book describes the current status of vascular access for patients with end-stage renal failure who require dialysis. The book highlights controversial areas and problems and describes differences in practice in USA and Europe. Vascular Access is the Achilles heel of dialysis. In theUnited States and Europe in 1999 there were in access of 400,000 patients maintained on dialysis. The success of this life sustaining procedure is dependant on being able to successfully access the circulation and obtain blood flows of between two and five hundred mls per minute three times a week.In 1964 Cimino and Brescia described what remains today the premier form of vascular access. Not long after the development of the Cimino Brescia fistula it became apparent that there were patients in whom it was either impossible or extremely difficult to create an adequate fistula for dialysis. Asdialysis technology has been applied to older and sicker patients this trend has continued, such that in the United States the majority of patients starting dialysis do not have a primary fistula. The maintenance of long-term vascular access in patients who do not have a primary fistula requiresconsiderably increased effort. In recent years a number of innovations have considerably increased the success of long- term vascular access in these patients. This book brings together these developments, including strategies to prospectively detect impending vascular access failure, and strategiesto pre-emptively prevent graft failure. Simultaneously with these developments there have been dramatic improvements in our understanding of the pathophysiology of graft failure, this improved understanding of the biology of access failure are beginning to bring to the clinical arena newerstrategies to delay graft failure.

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This book describes the current status of vascular access for patients with end-stage renal failure who require dialysis. The book highlights controversial areas and problems and describes differences in practice in USA and Europe. Vascular Access is the Achilles heel of dialysis. In theUnited States and Europe in 1999 there were in a...

Peter Conlon is at Duke University, and Nephrologist, Beaumont Hospital, Dublin. Michael Nicholson is at Leicester General Hospital.
Format:HardcoverPublished:February 24, 2000Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0192629425

ISBN - 13:9780192629425

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Table of Contents

Conlon/Nicholson/Schwab: PrefaceSchwab/Hannon: IntroductionWalshe/Farrell/Abraham: Acute Vascular AccessDavies/Huynh/Hagen: Pathophysiology of Vascular Access FailureBurger: Long-term outcome of different forms of vascular accessBlankenstijn: Cuffed catheter accessSexton/Kirkland: Dialysis access infectionNicholson/Murphy: Surgical considerations in vascular accessNicholson/Polo: Upper arm AV fistulaMcann: Vascular Access for the 'difficult' patientBesarab/Frinak: Strategies for prospective detection of graft dysfuctionRodriges: Percutaneous treatment of access dysfunctionBeathard: Options for restoration of thrombosed vascular access:ThrombolysisHenry: Options for restoration of thrombosed vascular access: SurgerySchwab: Dialysis outcomes quality initiative (DOQI)Polo: Vascular Access in childrenHimmelfarb: Novel therapies to prevent graft dysfunction