| Popis: |
When traditional sites of access have been exhausted, there are some percutaneous and surgical options remaining. These are salvage procedures and often have limited durability. The patient is now on a rapidly descending slope towards mortality, and discussions with the patient and their family should ensue. Options can be divided into catheter, AVG/AVF options and other options. Most catheter options are exotic, and associated with a high morbidity or mortality. Routes for catheter placement include translumbar, transhepatic, and via collaterals in the neck, chest or abdomen. AVG/AVF options are primarily surgical options discussed below. However, one can also attempt to salvage former accesses. |
