| [ Summary ] |
Because of the long delay associated with renal transplantation in Japan, the long term use of vascular access (VA), essential for hemodialysis, is anecessity. There has been a rapid increase in thenumber of cases where the construction or maintenance of VA is difficult because of the extended period of dialysis, the advancing age of patients and the introduction of dialysis in patients with preexisting vascular damage. In Japan, AVF is themost desirable and most frequently used form of hemodialysis. However, the number of cases where AVG must be used has gradually increased. In addition, because AVF and AVG place burdens on cardiac function, alternate methods of VA (arterial superficialization or catheterization) need to be considered. The main VA repair method has shifted to PTA or a modification of PTA but we have yet to find an indicator to determine whether PTA or a surgical procedure should be used in dealing with VA failure. |