Vascular access in hemodialysis. Surveillance and role of percutaneous transluminal angioplasty

: The function of vascular shunts in hemodialysis plays a vital role for the efficiency and effectiveness of replacement therapy. A study was performed in 147 patients undergoing periodical hemodialysis with distal FAV (no = 86), proximal FAV (no = 33), PTFE grafts (no = 23), Canaud-Tesio catheters (no = 7). A protocol for function evaluation was developed which also included the calculation of overall recirculation (R), that was found to be 10.8 + 7% (using the three blood sample method). In 28/143 patients the monitoring protocol recommended the use of angiography which identified abnormalities in 78% of cases, before the onset of thrombotic phenomena. In particular, surgical radiology was able to resolve 94% of cases in which angiography revealed a stenosis using percutaneous transluminal angioplasty and/or the insertion of one or more stents.