Dialysis Access (Shunts)

In a case of advan­ced renal dama­ge, when the kid­neys are no lon­ger able to ade­qua­te­ly puri­fy the blood of the body’s own toxins, arti­fi­ci­al hae­mo­dia­ly­sis is necessa­ry. For this pur­po­se, a spe­cial vascu­lar access is necessa­ry, over which a suf­fi­ci­ent­ly lar­ge volu­me of blood can flow and which can be safe­ly used in the long term. The blood is remo­ved for hae­mo­dia­ly­sis and then retur­ned to the cir­cu­la­ti­on. The­se acces­ses must be arti­fi­ci­al­ly crea­ted through sur­ge­ry.

The neces­si­ty and timing of dia­ly­sis, as well as the pla­cing of a dia­ly­sis access, are deter­mi­ned in clo­se coope­ra­ti­on with the atten­ding kid­ney spe­cia­lists (nephrolo­gists) and indi­vi­dual­ly adap­ted to the wis­hes and needs of the pati­ent. Befo­re the ope­ra­ti­on, a vascu­lar assess­ment is car­ri­ed out by means of an ultra­sound exami­na­ti­on.

In acu­te situa­ti­ons, e.g. acu­te kid­ney fail­u­re, it may be necessa­ry as an inte­rim solu­ti­on to insert a tem­pora­ry (tran­sito­ry) dia­ly­sis cathe­ter (atri­al cathe­ter), which can be used direc­t­ly for dia­ly­sis. This cathe­ter can be implan­ted direc­t­ly into a lar­ge vein, but can also be inser­ted less intrusi­ve­ly and almost invi­si­b­ly (tun­nel­led) from the out­si­de for lon­ger peri­ods of time.

  • Inser­ting a Dia­ly­sis Cathe­ter

In an acu­te situa­ti­on, it is necessa­ry to implant a tem­pora­ry dia­ly­sis cathe­ter into a lar­ger vein (Shal­don catheter/palindrome or atri­al cathe­ter).

  • App­li­ca­ti­on of an Arte­rio­venous Fis­tu­la or an Arte­rio­venous Shunt

An arti­fi­ci­al con­nec­tion is crea­ted bet­ween the arte­ry and vein on the arm, eit­her direc­t­ly bet­ween the body’s own ves­sels (arte­rio­venous fis­tu­la) or, if necessa­ry, in con­junc­tion with an arti­fi­ci­al vascu­lar repla­ce­ment (arte­rio­venous shunt).

  • Revi­si­on Pro­ce­du­re

In the case of pro­blems invol­ving pre­vious­ly estab­lished dia­ly­sis acces­ses (arte­rio­venous fis­tu­lae or shunts) in the form of blo­cka­ges, dila­ta­ti­ons or occlu­si­ons, revi­si­on sur­ge­ry is necessa­ry to main­tain their func­tio­n­a­li­ty, espe­ci­al­ly in older vascu­lar acces­ses.