Haemodynamic Evaluation of the Upper limb after atation of Proximal Foreann Arteriovenous Fistula for Haemodialysis in Patients with Chronic Renal Failure

Abstract

The maintenance of haemodialysis access continues to be one of the most challenging clinical problems facing vascular surgeons today. Since chronic haemodialysis has become available to older and sicker patients, more innovative methods of vascular access have been developed out of necessity. Also, with improved medical therapy, patients are living longer on dialysis than ever before.

To keep a functioning vascular access, multiple procedures at multiple sites are often required for patients who have been on chronic dialysis for years.

Patients, who have had most of their access vessels sites previously used, present major problems to both the nephrologists and the vascular surgeons.

This study was carried on twenty patients with end stage renal disease. All of the patients in the present study were subjected to the following:

../ Full history taking.

../ Clinical examination of both upper limbs

../ Meticulous examination of both arteries and veins of the upper limbs and evaluation of the possibility of arteriovenous fistula formation on the forearm vessels. ../ Mapping of the venous system of the upper limb with and without a tourniquet.