💥 Role of Stents in Dialysis Vascular Access - Tweetorial
⚡️Indications for Stent Use
⚡️Recent Clinical Trials of Stents in Dialysis Vascular Access
⚡️Complications associated with Stent Use
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@ASDINNews
#VascularAccessPearls
⚡️Arterio-venous (AV) Access
causes significant morbidity & mortality in patients on hemodialysis
⚡️Most AV access associated complications are due to vascular stenosis👇🏽
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⚡️Vascular Access care has evolved over the past 60 years:
-Scribner’s Shunt in 1960 ➡️
-Brescia-Cimino AVF in 1966 ➡️
-1st Balloon Angioplasty in 1981 ➡️
-1st Bare Metal Stent in 1988 ➡️
-1st Covered Stent in 1996 ➡️
-DCB use in 2012
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⚡️Despite these innovations, AV access stenosis remains a big problem
-Percutaneous Balloon Angioplasty (PTA) remains the 1st line therapy for stenosis but it is NOT very effective
-AVF patency after PTA is only 50% at 6-months & it is worse for AVGs👇🏽
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⚡️Neointimal Hyperplasia (NIH) causes vascular stenosis & it is due to:
-Hemodynamic stress
-Surgical trauma
-Cannulation needle trauma
-AVG
‼️But balloon angioplasty, the treatment for stenosis, can itself induce NIH & cause restenosis👇🏽
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