An Insight about Complications of endovascular intervention for failing arteriovenous fistula

Abstract

The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) has published guidelines for optimal clinical practices aimed at improving dialysis outcome and patient survival. The reporting standards recognize eight categories of complications related to hemodialysis access: thrombosis and failure to mature, bleeding, infection, aneurysm and pseudoaneurysm, seroma, ischemia or steal syndrome, venous hypertension and neuropathy. Venous outflow and anastomotic stenosis from neointimal hyperplasia are the main causes of thrombosis in mature AVF. Early thrombosis occurs more frequently with autogenous AVF and the majority of these occur within the first 5 days. Early thrombosis is usually attributed to technical fault. The commonest cause of late dysfunction in either fistula or grafts is venous stenosis, though the site of occurrence differs. Patients with ESRD have an increased risk of bleeding due to defects in hemostatic mechanisms secondary to uremia or acquired or inherited coagulation abnormalities. Patients on hemodialysis also have periodic heparin exposure. Cardiopulmonary complications: It is the leading cause of the death inpatients receiving chronic renal replacement therapy