The incidence of treated end stage renal disease (ESRD) continues to rise, particularly in the western world. Although renal transplantation is the treatment of choice for ESRD, the decline in the number of cadaveric organs, coupled with the rising demand for transplantation, means that an increasing number of patients will have to depend on dialysis. Vascular or peritoneal access is the Achilles' heel of any dialysis service.This book offers a clear description of the state of the art in providing and preserving a durable and reliable access. It also points the way to dialysis in the 21st century. The contributing authors are drawn from a wide background, with expertise in various aspects of dialysis access, including its history, the technique of placement, anaesthesia, radiology, nursing care and training of vascular access surgeons.There is currently a dearth of books on the subject of dialysis access. The few existing books on vascular access were written in the United States, with none from the UK. This volume is intended for use by transplant surgeons, general surgeons with an interest in vascular access, vascular surgeons, nephrologists, trainees and nurses. Dialysis services are expanding worldwide and this book is an invaluable guide for those involved in daily patient care and organisation of dialysis services.

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.

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 practical and comprehensive book provides "how-to" information on all aspects of access to the vascular system for hemodialysis, parenteral nutrition, chemotherapy, and resuscitation. Preoperative evaluation, operations, noninvasive procedures, complications, and other aspects are detailed. This edition provides increased coverage of non-interventional techniques and includes new chapters on management of thrombophilia in hemodialysis patients; modulation of the immune system to prevent myointimal hyperplasia; synthetic grafts; venous outflow stenting for salvage of vascular access procedures; and ultrasound in vascular access procedures. This book is essential for all clinicians treating patients who require vascular access, including vascular surgeons, general surgeons, nephrologists, dialysis technicians and nurses, radiologists, and cardiologists.

Dialysis Access: A Multidisciplinary Approach gives radiologists, nephrologists, and surgeons the complete knowledge base they need to deliver effective, coordinated care to dialysis patients with vascular access needs. This practical guide explains how to implement the National Kidney Foundation's Dialysis Outcomes Quality Initiative (DOQI) guidelines for vascular access and details procedures for creating vascular access...monitoring access failure...treating blocked access...and inserting and using catheters. Dr. Gray is the lead author for the Society of Cardiovascular and Interventional Radiology (SCVIR)'s Dialysis Access Reporting Standards. International contributors are expert interventional radiologists, nephrologists, and vascular access surgeons. Dialysis Access: A Multidisciplinary Approach fully integrates these specialties' perspectives.

Updated and revised, this 4th Edition is a practical, in-depth "how-to" guide to all aspects of vascular access surgery for a wide rage of patients and conditions. For each application, it illustrates regional anatomy and physiology ... discusses the indications for the various techniques... describes surgical procedures in depth...details the newest percutaneous interventions and thrombolysis...and presents the expected results and complications. Readers will also vital information on biomaterials, physiology of hemodialysis, and other core scientific topics. Details all types of vascular access, from uses in surgical procedures and transplantation to applications in renal failure as well as for long-term parenteral nutrition and chemotherapy. Reviews underlying anatomical and hemodynamic data. Provides all necessary technical information. Offers comprehensive coverage of how-to's for common and unusual patient presentations, in adults as well as pediatric patients Presents seven brand-new chapters with all other chapters thoroughly revised and updated. Emphasizes meeting the National Kidney Foundation outcome initiative (Dialysis Outcome Quality Improvement guidelines.) Features the latest techniques for autogenous fistula and basilic vein transposition. Includes use of imaging in central nervous catheterization. Provides the latest methods and outcome data on radiologic interventions. Discusses how to manage axillosubclavian thrombosis. Addresses how to avoid complications and difficult access problems.

The book is an on-the-spot reference for residents and medical students seeking diagnostic radiology fast facts. Its question-and-answer format makes it a perfect quick-reference for personal review and studying for board examinations and re-certification. Readers can read the text from cover to cover to gain a general foundation of knowledge that can be built upon through practice or can use choice chapters to review a specific subspecialty before starting a new rotation or joining a new service. With hundreds of high-yield questions and answer items, this resource addresses both general and subspecialty topics and provides accurate, on-the-spot answers. Sections are organized by subspecialty and body area, including chest, abdomen, and trauma, and chapters cover the anatomy, pathophysiology, differential diagnosis, hallmark signs, and image features of major diseases and conditions. Key example images and illustrations enhance the text throughout and provide an ideal, pocket-sized resource for residents and medical students.