This book describes the current status of vascular access for patients with end-stage renal failure who require dialysis. The book highlights controversial areas and problems and describes differences in practice in USA and Europe. Vascular Access is the Achilles heel of dialysis. In the United States and Europe in 1999 there were in access of 400,000 patients maintained on dialysis. The success of this life sustaining procedure is dependant on being able to successfully access the circulation and obtain blood flows of between two and five hundred mls per minute three times a week. In 1964 Cimino and Brescia described what remains today the premier form of vascular access. Not long after the development of the Cimino Brescia fistula it became apparent that there were patients in whom it was either impossible or extremely difficult to create an adequate fistula for dialysis. As dialysis technology has been applied to older and sicker patients this trend has continued, such that in the United States the majority of patients starting dialysis do not have a primary fistula. The maintenance of long-term vascular access in patients who do not have a primary fistula requires considerably increased effort. In recent years a number of innovations have considerably increased the success of long- term vascular access in these patients. This book brings together these developments, including strategies to prospectively detect impending vascular access failure, and strategies to pre-emptively prevent graft failure. Simultaneously with these developments there have been dramatic improvements in our understanding of the pathophysiology of graft failure, this improved understanding of the biology of access failure are beginning to bring to the clinical arena newer strategies to delay graft failure.
The proceedings from a conference on vascular access for hemodialysis (date and location not given) include 32 papers and transcripts from seven panel discussions. Topics include intimal hyperplasia, radiological intervention, unusable brescia fistulas, the Lifesite hemodialysis access system, vascular access infections, Medicare's ESRD program, transposed brachiobasilic fistula, basilic vein transposition, ischemic monomelic neuropathy, grafts, HIV, femoral catheters, the role of nursing, treatment of the elderly, and CPT and ICD-9 coding. c. Book News Inc.
Decision-making regarding the route of access to minimize procedural complications, especially in patients with unusual or complicated vascular anatomy, is extremely important for successful vascular access surgery. Several techniques for vascular access are widely disputed in the context of achieving optimal clinical outcomes. This book discusses various clinical aspects of vascular access to enrich our knowledge and understanding of the contemporary methodology and management of vascular access for a broad range of purposes. In four sections, this book examines the following topics: 1. Vascular Access: Methodology and Contemporary Management; 2. Vascular Access and Reparative Surgery; 3. Vascular Access Failure; and 4. Risk Stratification in Vascular Access.
This comprehensive reference details the techniques for establishing vascular access for hemodialysis and other acute and chronic conditions that require access to the circulation along with peritoneal dialysis access methods. Includes over 960 references and more than 160 tables, figures, and photographs. Vascular Access in Clinical
This book is a compilation of common and uncommon surgical and ancillary techniques that we have found useful in the multiorgan transplantation pro gram at the University of Minnesota. Descriptions of these techniques are not available at a single source elsewhere. Use the book as a teaching aid, a source of workable techniques, and as a reference for individuals with relatively little experience in a particular area of transplantation. Because of the varying levels of expertise of our readers, vascular access is described in exquisite detail, as it is aimed at an audience of individuals who want to learn the fine points about how to prolong the function of shunts. The chapter on organ preservation is aimed at the surgeon or beginning technician who must learn how to do it from scratch--even the catalogue numbers of the necessary equipment are included. In contrast the chapters on heart, liver, and pancreas transplantation, while omitting fine points of suture technique, concentrate on the essential principles and safeguards. Individuals contemplating such transplants are presumably already schooled in the fine points of surgical technique. The chapters on cadaver organ donation are perhaps the most innovative. They represent our attempt to reorganize organ donation in a way that will provide the greatest usefulness of each donor as a source for multiple organs for transplantation. We hope that the book will become available to centers that, while not performing liver, pancreas, or heart transplants, wish to serve as donation centers.
This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.
This thoroughly updated and revised text provides an overview of vascular disease and presents specific nursing management strategies for each vascular disorder. New technology for diagnostic evaluation of vascular disease and non-operative management of vascular disease is covered in detail.
When the external Quinton-Scribner arteriovenous shunt was developed in 1960, and, a little later, the internal Brescia-Cimino arteriovenous fistula was developed as a vascular access for hemodialysis, thereby making possible regular dialysis therapy of chronic uremic patients, many nephrologists became surgeons, having learned the type of vascular surgery related to hemodialysis quite well. The same series of events occurred with regards to peritoneal dialysis with the introduction of the Tenckhoff catheter and the need for gaining a permanent access to the peritoneum for chronic ambulatory peritoneal dialysis (CAPD) therapy. With time, however, problems relating to vascular and peritoneal access have forced many nephrologists to give up their surgery; meanwhile, many surgeons have become quite expert in some sophisticated techniques relating to dial ysis (e. g., vessel grafting, prosthesis implantation, etc.). Today, whether or not involved in this type of surgery, both nephrologists and surgeons remain interested in knowing all available access devices for dialysis as well as the surgical techniques involved. However, all nephrologists involved in dialysis must know how to prevent or treat complications related to dialysis access. Thus, it appeared to me to be quite advisable to have a book in my series, Topics in Renal Medicine, dealing with vascular and peritoneal access for dialysis.
This updated and revised third edition of Vascular Surgery: Cases, Questions and Commentaries provides a unique collection of real-life case histories, written by experts, that highlights the diversity of problems encountered in vascular surgery. With an international panel of contributors, many of whom are also examiners on the UK, European or American Boards in Vascular Surgery, this book familiarizes the reader quickly with day-to-day clinical practice. Case studies are presented in question-and-answer format and have been widely referenced to reassure the reader that their contents are established best practice. Most cases are accompanied by multiple x-rays or color illustrations for visual clarity. This book serves as a teaching resource for vascular trainees or practitioners who are reviewing for the oral board exam or practitioners who wish to refresh their expertise with an interactive source of information. It also provides established practitioners the wherewithal to review the current standards of practice in vascular surgery.
Substantially revised to reflect the most recent surgical techniques and practices, this reference describes the most effective strategies to prevent, identify, and manage complications in vascular surgery-guiding surgeons through patient selection; instances of entrapment, malpositioning, and rupture; emerging endovascular treatments; and specific device-related complications.
This practical guide is devoted to vascular diseases as dealt with by vascular surgeons. It is written with the collaboration of other specialists attending to vascular diseases. The book provides a concise overview of the current level and standards of care of vascular diseases in the European Union, and fills the need of vascular specialists who prepare for the U.E.M.S. exam. The text is well-structured and contains practical guidelines. The readership that will benefit most will be trainees and practitioners in vascular surgery, angiology and also practicing physicians. However, the book will also be valuable to physicians of other specialties.
Winner of a HIGHLY COMMENDED AWARD in the Surgery category of the 2007 BMA Medical Book Competition. The first edition published in 1999, was described as a "longed for addition to the literature", and as a text that "cannot be compared with any other book on vascular surgery" (Lancet 2000; 355: 1918). At the time it was different; a book to help busy clinicians sift through surgical research and use it to make sensible decisions for their clinical practice. The challenge for this second edition is to produce something better still. The new edition is larger and more comprehensive, thanks to valuable suggestions from colleagues and reviewers. The text is as accessible as possible, with short chapters, recommendations for management, comprehensive referencing and full colour illustration. It belongs on the shelf, or in the briefcase of everyone who has to treat patients with vascular disease.
