Roca-Tey Ramon, Ibeas José, Moreno Teresa, Gruss Enrique, Merino José Luis, Vallespín Joaquín, Hernán David, Arribas Patricia
1 Department of Nephrology, Hospital de Mollet, Fundació Sanitària Mollet, Barcelona, Spain.
2 Department of Nephrology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain.
J Vasc Access. 2018 Sep;19(5):422-429. doi: 10.1177/1129729818761307. Epub 2018 Mar 15.
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access." We will analyze the current evidence on conflicting topics such as the value of the flow-based screening methods for the arteriovenous access surveillance or the role of Doppler ultrasound as the imaging exploration to confirm suspected stenosis. In addition, the concept of significant stenosis and the criteria to perform the elective intervention for stenosis were reviewed. The adoption of these guidelines will hopefully translate into a reduced risk of thrombosis and increased patency rates for both arteriovenous fistulas and grafts.
西班牙血管通路多学科小组(GEMAV)包括来自五个相关科学学会的专家(肾脏病学(S.E.N.)、血管外科(SEACV)、介入放射学(SERAM - SERVEI)、传染病学(SEIMC)和肾脏病护理(SEDEN)),在伊比利亚美洲 Cochrane 中心的方法学支持下,制定了西班牙血液透析血管通路临床指南。本文总结了该指南中题为“动静脉通路的监测与监视”一章的主要内容。我们将分析当前关于一些存在争议话题的证据,比如基于流量的筛查方法在动静脉通路监测中的价值,或者多普勒超声作为确认疑似狭窄的影像学检查手段的作用。此外,还对严重狭窄的概念以及对狭窄进行择期干预的标准进行了综述。希望采用这些指南能够降低动静脉内瘘和移植物的血栓形成风险,并提高通畅率。