| Theme |
Chronic Kidney Disease (CKD) -- A new tide flows around the world |
| Title |
The view point of a vascular surgeon |
| Author |
Noriyoshi Murotani |
Chiba Social Insurance Hospital |
| Author |
Seiji Hori |
Chiba Social Insurance Hospital |
| Author |
Satoshi Hikita |
Chiba Social Insurance Hospital |
| Author |
Yukihiro Matsuda |
Chiba Social Insurance Hospital |
| Author |
Hitoshi Hayashi |
Maeda Hospital |
| Author |
Hiroshi Nishijima |
Chiba Social Insurance Hospital |
| [ Summary ] |
The number of patients who are difficult to operate on due to vascular access problems is increasing in relation to the increase in the number of elderly patients and those with diabetic nephropathy. The timing of vascular access operations from the viewpoint of a vascular surgeon is presented. It is important to perform vascular access operations earlier, before the initiation of hemodialysis, to avoid catheter related complications.
The following points concerning vascular access operations should be kept in mind : (1) Strip the vessels gently and avoid kinks in the veins. (2) Optimum anastomotic diameter should be maintained. Do not expand over 5 mm in diameter when access is being made in the proximal side of the arm. (3) Suture the proximal side of the anastomotic area with a direct view. (4) Evaluate the efficacy of vascular access personally. |