Archived Information for Change Concept #9

Tools, resources, documents and presentations on this page are for historical purposes and may not reflect the current recommendations and/or practice guidelines.

 

Tools

 

 Monthly Vascular Access Referral/Intervention Log

 

Vascular Access Tracking Tool (VATT)

 

Infection Tracking Tool

 

The Salvage of Aneurysmal Fistulae Utilizing a Modified Buttonhole Cannulation Technique and Multiple Cannulators
 

Dynamic Venous Pressure (DVP) Monitoring & Follow-Up


Literature

MONITORING:

  1. A Comparison of Methods for the Measurement of Hemodialysis Access Recirculation, by C Basile, G Ruggieri, L Vernaglione, A Montanaro, and R Giordano. From J Nephrol 2003 Nov/Dec; 16(6): pp. 908-13.
     
  2. K/DOQI Clinical Practice Guidelines for Vascular Access 2000. National Kidney Foundation. From Am J Kidney Dis 37;S137-S181 (supl l). II. Monitoring, Surveillance, and Diagnostic Testing, Guideline 11.
     
  3. Physical Examination of the Dialysis Vascular Access, by GA Beathard. From Seminars in Dialysis 1998 Jul-Aug; 11(4): pp 231-236.
     
  4. Use of the fistula assessment monitor to detect stenoses in access fistulae by Gani JS, Fowler PR, Steinberg AW, Wlodarczyk JH, Nanra RS, Hibberd AD. From Am J Kidney Dis, 1991 Mar;17(3):303-6. Routine fistula assessment monitoring could reduce inappropriate angiography and detect clinically significant silent stenoses. It is an ideal method for monitoring arteriovenous access fistulae.
     
  5. Are hemodialysis access flow measurements by ultrasound dilution the standard of care for access surveillance?, by Garland JS, Moist LM, Lindsay RM. From Adv Ren Replace Ther, 2002 Apr;9(2):91-8. Access flow measurements are the best tests currently available to screen for access dysfunction, and as preventative interventions, such as angioplasty and surgery, are successful, they should be regarded as the present standard of care. This would appear to be a cost-effective strategy. Furthermore, the method of choice for access flow measurement is by ultrasound dilution technology.
     
  6. Access blood flow as a predictor of early failures of native arteriovenous fistulas in hemodialysis patients, by Kim YO, Yang CW, Yoon SA, Chun KA, Kim NI, Park JS, Kim BS, Kim YS, Chang YS, Bang BK. From Am J Nephrol, 2001 May-Jun;21(3):221-5. Access blood flow measurements using color doppler ultrasound during early postoperative periods are useful parameters in predicting an early failure of a native AVF in hemodialysis patients.
     
  7. Predictive measures of vascular access thrombosis: a prospective study, by May RE, Himmelfarb J, Yenicesu M, Knights S, Ikizler TA, Schulman G, Hernanz-Schulman M, Shyr Y, Hakim RM. From Kidney Int, 1997 Dec;52(6):1656-62. If simple to use, cost-effective devices to measure dialysis access blood flow become readily available, the measurement of access blood flow will likely become the method of choice for screening of PTFE vascular access dysfunction in hemodialysis patients.
     
  8. Vascular Access Blood Flow Monitoring Reduces Access Morbidity and Costs, by P McCarley, RL Wingard, Y Shyr, W Pettus, RM Hakim and TA Ikizler. From Kidney Int 2001 Sep; 60(3): pp 1164-72).
     
  9. Hemodialysis arteriovenous fistula maturity: US evaluation by Robbin ML, Chamberlain NE, Lockhart ME, Gallichio MH, Young CJ, Deierhoi MH, Allon M. From Radiology, 2002 Oct;225(1):59-64. Ultrasonographic US measurements of AVF at 2-4 months in patients undergoing hemodialysis are highly predictive of fistula maturation and adequacy for dialysis.
     
  10. Detection and treatment of dysfunctional hemodialysis access grafts: effect of a surveillance program on graft patency and the incidence of thrombosis, by Safa AA, Valji K, Roberts AC, Ziegler TW, Hye RJ, Oglevie SB. From Radiology, 1996 Jun;199(3):653-7.
     
  11. A review of vascular access monitoring techniques: what works best?, by Sands JJ. From Nephrol News Issues. 2003 Jul;17(8):86-7.
     
  12. Physical examination versus normalized pressure ratio for predicting outcomes of hemodialysis access interventions, by Trerotola SO, Ponce P, Stavropoulos SW, Clark TW, Tuite CM, Mondschein JI, Shlansky-Goldberg R, Freiman DB, Patel AA, Soulen MC, Cohen R, Wasserstein A, Chittams JL. From J Vasc Interv Radiol. 2003 Nov;14(11):1387-94. The authors believe that physical examination of dialysis access should supplant pressure measurements as an endpoint of intervention and should serve as an essential component of quality assurance of access interventions.
     
  13. Access flow monitoring of patients with native vessel arteriovenous fistulae and previous angioplasty, by Tonelli M, Hirsch D, Clark TW, Wile C, Mossop P, Marryatt J, Jindal K. J Am Soc Nephrol, 2002 Dec;13(12):2969-73. Continued screening after correction of first stenoses appears reasonable, because of both the frequency of recurrent stenosis and the success of repeat intervention.
     
  14. A practitioner's resource guide to physical examination of dialysis vascular access, by Beathard, G. Physical examination is easy to perform, inexpensive, and effective. This article provides detailed instruction on physical examination of the ESRD patient both prior to access placement and after, including pictures. Provided with permission by the author.

MAINTENANCE:

  1. Tunneled Jugular Small-Bore Central Catheters as an Alternative to Peripherally Inserted Central Catheters for Intermediate-term Venous Access in Patients with Hemodialysis and Chronic Renal Insufficiency, by Sasadeusz KJ, Trerotola SO, Shah H, Namyslowski J, Johnson MS, Moresco KP, Patel NH. Radiology (1999) 213: pp 303-306. For more information about this article, please visit the Radiology website.
     
  2. Salvage of immature forearm fistulas for haemodialysis by interventional radiology, by L Turmel-Rodrigues et al. From Nephrol Dial Transplant (2001), 16: pp 2365-2371. A six-year study of interventional radiology techniques for handling thrombosed immature AVF.
     
  3.  Quality improvement guidelines for percutaneous management of the thrombosed or dysfunctional dialysis access, by Aruny JE, Lewis CA, Cardella JF, Cole PE, Davis A, Drooz AT, Grassi CJ, Gray RJ, Husted JW, Jones MT, McCowan TC, Meranze SG, Van Moore A, Neithamer CD, Oglevie SB, Omary RA, Patel NH, Rholl KS, Roberts AC, Sacks D, Sanchez O, Silverstein MI, Singh H, Swan TL, Towbin RB, Trerotola SO, Bakal CW. From J Vasc Interv Radiol, 2003 Sep;14(9 Pt 2):S247-53.
     
  4. Aggressive treatment of early fistula failure, by Beathard GA, Arnold P, Jackson J, Litchfield T. From Kidney Int, 2003 Oct;64(4):1487-94. If correctable pathology is detected in patients with early fistula failure, the incidence of correctable lesions is relatively high and an aggressive therapeutic approach can be expected to have a high yield.
     
  5. Management of complications of endovascular dialysis access procedures, by Beathard GA. From Semin Dial, 2003 Jul-Aug;16(4):309-13.
     
  6. Impact of secondary procedures in autogenous arteriovenous fistula maturation and maintenance, by Berman SS, Gentile AT. From J Vasc Surg, 2001 Nov;34(5):866-71. Aggressive assessment of immature or failing autogenous AV fistulas for correctable lesions should be included in any hemodialysis practice to optimize their use and exploit the superiority of the native fistula.
     
  7. Interventions to Promote Fistula Maturation, by LC Dinwiddie. From Neph Nursing J 2002 Aug; 29(4): pg 377, pg 402.
     
  8. Treatment of "swing point stenoses" in hemodialysis arteriovenous fistulae, by Falk A, Teodorescu V, Lou WY, Uribarri J, Vassalotti JA. From Clin Nephrol, 2003 Jul;60(1):35-41. Non-maturing or poorly functioning AVF frequently have stenoses in the outflow vein at the original site of surgical vein mobilization.
     
  9. Impact of reintervention for failing upper-extremity arteriovenous autogenous access for hemodialysis, by Hingorani A, Ascher E, Kallakuri S, Greenberg S, Khanimov Y. From J Vasc Surg, 2001 Dec;34(6):1004-9. This review suggests that simple and extended salvage procedures may allow maturation and add to the life span of AVFs for hemodialysis. In addition, these data suggest an advantage for open techniques as compared with percutaneous techniques but only in terms of requiring fewer subsequent procedures.
     
  10. Interventional strategies for haemodialysis fistulae and grafts: interventional radiology or surgery?, by Konner K. From Nephrol Dial Transplant, 2000 Dec;15(12):1922-3.
     
  11. Surgical salvage of failed radiocephalic arteriovenous fistulae: techniques and results in 29 patients, by Oakes DD, Sherck JP, Cobb LF. From Kidney Int, 1998 Feb;53(2):480-7.
     
  12. Procedural success and patency after percutaneous treatment of thrombosed autogenous arteriovenous dialysis fistulas, by Rajan DK, Clark TW, Simons ME, Kachura JR, Sniderman K. From J Vasc Interv Radiol, 2002 Dec;13(12):1211-8.
     
  13. Salvage of occluded autologous arteriovenous fistulae, by Schon D, Mishler R. From Am J Kidney Dis, 2000 Oct;36(4):804-10.
     
  14. Dilatation and declotting of arteriovenous accesses, by Turmel-Rodrigues L. From Therap Apher Dial, 2003 Apr;7(2):244-51.
     
  15. Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts, by interventional radiology by Turmel-Rodrigues L, Pengloan J, Baudin S, Testou D, Abaza M, Dahdah G, Mouton A, Blanchard D. From Nephrol Dial Transplant, 2000 Dec;15(12):2029-36.
     
  16. Endovascular intervention for the failing vascular access, by Vesely TM. From Adv Ren Replace Ther, 2002 Apr;9(2):99-108. When appropriate lesions are treated, angioplasty is a fast, easy, and safe procedure that can extend to patency of a hemodialysis graft or fistula.
     
  17. Results of arteriovenous fistula revision in the forearm by Yasuhara H, Shigematsu H, Muto T. From Am J Surg, 1997 Jul;174(1):83-6. Revision is a reliable procedure for salvaging a failed fistula, which yields an acceptable patency rate regardless of the patient's risk factors for arteriosclerosis.
     
  18. Prospective Evaluation Of Failure Modes In Autogenous Radiocephalic Wrist Access For Haemodialysis, by JH Tordoir, P Rooyens, R Dammers, FM van der Sande, M de Haan, TI Yo. Nephrol Dial Transplant. 2003 Feb;18(2):378-83.
     
  19. Increasing AV fistula creation: the Akron experience, by Spuhler CL, Schwarze KD, Sands JJ. Nephrol News Issues, May 2002, 44-49

 

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