Thigh Grafts: A Preferable Alternative to Catheters when Upper Extremity Access Sites are Exhausted
| Autor: | Kenneth Abreo, Sunanda J. Ram |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Dialysis adequacy Vascular disease business.industry Mortality rate medicine.medical_treatment Population Thigh medicine.disease Surgery Catheters Indwelling medicine.anatomical_structure Renal Dialysis Nephrology Arm medicine Humans Hemodialysis Complication business education Dialysis |
| Zdroj: | Seminars in Dialysis. 22:469-471 |
| ISSN: | 1525-139X 0894-0959 |
| Popis: | Hemodialysis patients with failed upper extremity (arm) access sites comprise 5-10% of the dialysis population. In these patients, arm vessels are either unsuitable for access placement due to trauma or peripheral vascular disease, or have been exhausted following dialysis usage. Synthetic grafts in the lower extremity (thigh) would benefit these patients, but surgeons are often reluctant to place them, due to concerns of infection and vascular complications. As a result, these patients receive tunneled central venous catheters as their permanent dialysis access. Recent studies have shown, however, that survival and complication rates of thigh grafts are similar to arm grafts and fistulas. Moreover, thigh grafts have lower infection and mortality rates than catheters and provide higher blood flows and dialysis adequacy. In this editorial we argue that thigh grafts are the better option in patients who have lost all arm access sites; they should be placed in preference to tunneled central venous catheters. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|