Patients with acute kidney failure (AKF) and chronic kidney failure (CKF) require an appropriate vascular access for hemodialysis [1]. Vascular access is needed to allow blood flow through an extracorporeal circulation system with a blood pump connected to a hemodialysis monitor driving the blood through a dialysis filter (dialysator). Satisfactory levels of blood flow range between 300 and 400...

Dr. Steve J. Schwab (Vice-Chairman, Department of Medicine, Duke University Medical Center, and Professor of Medicine, Duke University School of Medicine, Durham, North Carolina, USA): This case exemplifies the current state of the art for the management of vascular access for hemodialysis. The predominant form of vascular access currently in the United States is the polytetrafluoroethylene (PT...

Nephrologists need to deal with the problem of vascular access management in the same manner as the other major problems that affect our dialysis patients. We need to become experts in vascular access and we need to occupy a pivotal position in directing the decisions that are made that affect dialysis patient welfare. An integrated vascular access management strategy is required. Optimally, th...

A progressive rise in the number of patients accepted for renal replacement therapy has been reported world wide [1]. Permanent vascular access (VA) is the life-line for the majority of these patients, when hemodialysis is the treatment of choice. Thus, the successful creation of permanent vascular access and the appropriate management to decrease the complications is mandatory. A well function...

Background: Vascular access remains a challenge in many patients who require ventricular support using the Impella catheter (Abiomed, Inc., Danvers, MA) for high risk percutaneous coronary intervention (PCI). Specifically, limitations of vessel size, calcification and tortuosity may make large bore access difficult. Balloon expandable (BE) sheath technology allows for the insertion of a smaller...

BACKGROUND Intraosseous (IO) access represents a reliable alternative to intravenous vascular access and is explicitly recommended in the current guidelines of the European Resuscitation Council when intravenous access is difficult or impossible. We therefore aimed to study the efficacy of the intraosseous needle driver EZ-IO in the prehospital setting. METHODS During a 24-month period, all c...

OBJECTIVE Intraosseous access (IO) is becoming increasingly accepted in adult populations as an alternative to peripheral vascular access; however, there is still insufficient evidence in large patient groups supporting its use. METHODS Retrospective review. This paper reports on the use of IO devices over a 7-year period from August 2006 to August 2013 during combat operations in Afghanistan...

Persistent left superior vena cava is the most common congenital venous anomaly of the thoracic venous system, occurring in 0.3% to 0.5% of individuals in the general population. It may remain asymptomatic throughout life and be incidentally found in healthy individuals undergoing vascular procedures such as venous access device placements and endovascular cardiac interventions. Here we present...