Ten-Years Experience with Establishing A-V Shunts

J 2007

Ten-Years Experience with Establishing A-V Shunts

KONEČNÝ, Zdeněk, Zdeněk KŘÍŽ, Martin DVOŘÁK, Robert VLACHOVSKÝ, Tomáš NOVOTNÝ et. al.

Basic information

Original name

Ten-Years Experience with Establishing A-V Shunts

Name in Czech

Naše zkušenosti se zakládáním A-V zkratů za 10- leté období

Authors

KONEČNÝ, Zdeněk (203 Czech Republic, guarantor), Zdeněk KŘÍŽ (203 Czech Republic), Martin DVOŘÁK (203 Czech Republic), Robert VLACHOVSKÝ (203 Czech Republic), Tomáš NOVOTNÝ (203 Czech Republic) and Jan BUČEK (203 Czech Republic)

Edition

Scripta Medica Brno, Brno, LF MU, 2007, 1211-3395

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/07:00032880

Organization unit

Faculty of Medicine

Keywords in English

arteriovenous shunt; hemodialysis; surgery

Abstract

ORIG CZ

V originále

The role of a surgeon cooperating with a hemodialyzing centre is to secure the access to the vascular system of a patient with renal failure for his/her permanent, repeated, safe and painless connection to the artificial kidney. It means the establishing of AV shunt that provides both sufficient supply of blood for the extracorporeal circulation through an artificial kidney and its adequate return from the apparatus into the patients circulatory system. A subcutaneous AV shunt ought to be, if possible, direct, estabished by a simple method and in the most peripheral site. The history of establishing an accesse in patients involved in the hemodialyzing programme started at our clinic in 1971. Within 1996 to 2006, totally 1453 accesses for hemodialysis were established. Out of them, Brescia Ciminos variation was applied in 62%, various types of AV shunt in the cubital fossa in 20%, other vascular possibilities in 9.5%, Diastat implantation in 0.5%, an access for peritoneal dialysis in 8%. Most frequent surgeries were carried out under local anaesthesia in 83.0%, block anaesthesia was applied in 16%, and general anaesthesia in 1.0%. Complications due to an access for hemodialysis comprise thromboses, stenoses, aneurysmatic degradation of an output vein, hyperfunction (steal phenomena) of AV shunts, infections of implanted Diastats. The establishing of an AV shunt is indicated by a nephrologist, which is one of principles for establishing accesses for hemodialysis observed at our clinic. An angiosurgeon decides the AV shunt variation. If possible, interventions are performed under local anaesthesia. The aim is to utilize maximally the patients autologous material. Diastat is implanted after exhausting all the possibilities of establishing AV shunts from using the superficial venous system. When solving complications, early interdisciplinary cooperation of a nephrologist, intervention radiologist and angiosurgeon is important. Patients colaboration is necessary for peritoneal dialysis, the abdominal cavity must be without larger adhesions or inflammation for inserting a catheter. Detailed instructing a patient about the principles of maintaining an AV shunt is of great importance. Concluding, the length of functioning the access for hemodialysis depends on correct indication for its establishing, precise performance, careful use and, last but not least, increased care of an access by the patient himself.

In Czech

Publikace seznamuje s našimi zkušenosti se zakládáním A - V zkratů za 10 - leté odbobí

Citovat

KONEČNÝ, Zdeněk, Zdeněk KŘÍŽ, Martin DVOŘÁK, Robert VLACHOVSKÝ, Tomáš NOVOTNÝ and Jan BUČEK. Ten-Years Experience with Establishing A-V Shunts. Scripta Medica Brno. Brno: LF MU, 2007, vol. 80, No 3, p. 127-253. ISSN 1211-3395.

@article{749607,
   author = {Konečný, Zdeněk and Kříž, Zdeněk and Dvořák, Martin and Vlachovský, Robert and Novotný, Tomáš and Buček, Jan},
   article_location = {Brno},
   article_number = {3},
   keywords = {arteriovenous shunt; hemodialysis; surgery},
   language = {eng},
   issn = {1211-3395},
   journal = {Scripta Medica Brno},
   title = {Ten-Years Experience with Establishing A-V Shunts},
   volume = {80},
   year = {2007}
}

TY  - JOUR
ID  - 749607
AU  - Konečný, Zdeněk - Kříž, Zdeněk - Dvořák, Martin - Vlachovský, Robert - Novotný, Tomáš - Buček, Jan
PY  - 2007
TI  - Ten-Years Experience with Establishing A-V Shunts
JF  - Scripta Medica Brno
VL  - 80
IS  - 3
SP  - 127
EP  - 127
PB  - LF MU
SN  - 12113395
KW  - arteriovenous shunt
KW  - hemodialysis
KW  - surgery
N2  - The role of a surgeon cooperating with a hemodialyzing centre is to secure the access to the vascular system of a patient with renal failure for his/her permanent, repeated, safe and painless connection to the artificial kidney. It means the establishing of AV shunt that provides both sufficient supply of blood for the extracorporeal circulation through an artificial kidney and its adequate return from the apparatus into the patients circulatory system. A subcutaneous AV shunt ought to be, if possible, direct, estabished by a simple method and in the most peripheral site. The history of establishing an accesse in patients involved in the hemodialyzing programme started at our clinic in 1971. Within 1996 to 2006, totally 1453 accesses for hemodialysis were established. Out of them, Brescia Ciminos variation was applied in 62%, various types of AV shunt in the cubital fossa in 20%, other vascular possibilities in 9.5%, Diastat implantation in 0.5%, an access for peritoneal dialysis in 8%. Most frequent surgeries were carried out under local anaesthesia in 83.0%, block anaesthesia was applied in 16%, and general anaesthesia in 1.0%. Complications due to an access for hemodialysis comprise thromboses, stenoses, aneurysmatic degradation of an output vein, hyperfunction (steal phenomena) of AV shunts, infections of implanted Diastats. The establishing of an AV shunt is indicated by a nephrologist, which is one of principles for establishing accesses for hemodialysis observed at our clinic. An angiosurgeon decides the AV shunt variation. If possible, interventions are performed under local anaesthesia. The aim is to utilize maximally the patients autologous material. Diastat is implanted after exhausting all the possibilities of establishing AV shunts from using the superficial venous system. When solving complications, early interdisciplinary cooperation of a nephrologist, intervention radiologist and angiosurgeon is important. Patients colaboration is necessary for peritoneal dialysis, the abdominal cavity must be without larger adhesions or inflammation for inserting a catheter. Detailed instructing a patient about the principles of maintaining an AV shunt is of great importance. Concluding, the length of functioning the access for hemodialysis depends on correct indication for its establishing, precise performance, careful use and, last but not least, increased care of an access by the patient himself.
ER  -

KONEČNÝ, Zdeněk, Zdeněk KŘÍŽ, Martin DVOŘÁK, Robert VLACHOVSKÝ, Tomáš NOVOTNÝ and Jan BUČEK. Ten-Years Experience with Establishing A-V Shunts. \textit{Scripta Medica Brno}. Brno: LF MU, 2007, vol.~80, No~3, p.~127-253. ISSN~1211-3395.

Detailed Information on Publication Record