Role of Interventional Radiology In The Management of The Complicated Hemodialysis Shunt

Abstract

The prevalence of complications of the dialysis arteriovenous fistula is high and greater attention should be paid to the prevention of these complications. Early diagnosis and appropriate treatment is essential to improve the quality of life in patients on hemodialysis. Radiologistscan play a critical role in the diagnosisand treatment of the dialysis AVFs. Digital angiography ishelpful in elaborating a vascular map for endovascular treatment.

Early complications of AV access which are often related to technical/surgical problems are thrombosis, bleeding, pseudoaneurysm and localized noninfectious fluid collections. Late complications include arterial steal phenomenon, venous hypertension, high cardiac output heart failure, and neuropathy.

The leading cause of failure of a prosthetic arteriovenous hemodialysis-access graft is venous anastomotic stenosis. Balloon angioplasty, the first-line therapy, has a tendency to lead to subsequent recoil and restenosis; however, no other therapies have yet proved to be more effective.