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Between April 2016 and September 2023, our team has performed 2,357 vascular access surgeries for dialysis, surgeries performed in Argentina and Saudi Arabia. Catheter placement can be avoided in a patient with complicated fistula in more than 80%.
Purpose
Take care of the vascular capital of patients who are on hemodialysis, and avoid central stenosis caused by hemodialysis catheters. Especially long terms catheters
With 2355 surgeries were:
- new fistulas with vein 691
- New fistulas with prosthesis 147
- Fistula Stenosis: 736
- Fistula Aneurysm Repair 87
- Robbery Syndrome 45
- Prosthesis infections 52
Graphic 1.
- Permanent and temporary catheters 599
Techniques used:
Stenosis
Repair was performed, depending on the type of fistula, using various techniques from our arsenal of repairs, in more than 90% with conventional surgery, the remaining 10% between endovascular and hybrid surgery. The average catheter use in these cases of repair is very low.
In 2,357 surgeries, a catheter was placed in 599 patients, 25.4%.
The patients with fistula repair was 920; only in 139 patients, were catheters placed, 15%.
In other words, catheters could be avoided in 85% of the operated patients with a previous fistula.
The secret to a low incidence of catheter placement and being able to repair fistulas is teamwork, where:
-the patient, who must be perfectly informed of their pathology and care their vascular access.
- Nurses who must know the techniques for using vascular access, and early warning about any alteration.
- nephrologists who must be attention to the results of good dialysis, and the proper functioning of vascular access.
- surgeons, who must be in line with the entire hemodialysis team and discuss the most convenient option for the perform and maintenance of vascular access.
Carry out repairs, before occlusion, aneurysms rupture, severe ischemia due to theft, etc.
In addition, surgeons must perform more than 90% of fistulas with veins.