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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.