Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Abstract

A wide variety of diagnostic and minimally invasive modalities is currently available to radiologists for providing sufficient medical care for dialysis patients. In addition to clinical examination, ultrasound is the first line imaging method in suspected dialysis vascular access dysfunction. The percutaneous approach is the primarily recommended therapeutic option in many cases. This article reviews the current diagnostic and therapeutic methods in dialysis vascular access insufficiency.

Key Points:

• Vascular access dysfunction is often elicited by stenosed vessels, which are regularly associated with concomitant thrombosis.

• Stenoses are commonly observed in the anastomosis, vascular access vein and also in the central venous system.

• Beside the clinical examination, sonography is the diagnostic method of first choice.

• Percutaneous balloon dilatation frequently is the first treatment option.

Citation Format:

• Kamper L, Faizy TD, Haage P. Diagnosis and Treatment of Insufficient Dialysis Vascular Access. Fortschr Röntgenstr 2015; 187: 360 – 371

Zusammenfassung

Zur adäquaten medizinischen Betreuung des Dialysepatienten stehen dem Radiologen heute eine Vielzahl von diagnostischen und minimalinvasiven Methoden zur Verfügung. Neben der klinischen Untersuchung ist die Sonografie die bildgebende Methode der ersten Wahl bei vermuteter Dialyseshuntdysfunktion. Therapeutisch stellt die perkutane Behandlung oftmals die primär empfohlene Option dar. Die vorliegende Arbeit gibt einen Überblick über den derzeitigen Stand diagnostischer und therapeutischer Verfahren bei Malfunktion des Dialyseshunts.

Key words

vascular - angioplasty - ultrasound - venography - CT angiography

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