Department of Vascular Surgery, Parc Taulí University Hospital, Parc Taulí Research and Innovation Institute (I3PT), Autonomous University of Barcelona, Barcelona, Spain.
Department of Internal Medicine, Sant'Anna of Advanced Studies - Life Sciences Institute, University of Pisa, Pisa, Italy.
J Vasc Access. 2021 Nov;22(1_suppl):9-17. doi: 10.1177/11297298211046827. Epub 2021 Sep 27.
Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.
血管通路对于血液透析至关重要，因为它与透析质量和相关发病率有关。因此，从创建血管通路的那一刻起，就必须对其进行监测和持续监测，以防止成熟和血栓形成失败。当主要目标是在尽可能减少并发症的情况下获得足够的血管通路流量时，需要多学科协作。起点，也许是最重要的起点，是血管通路规划。这一规划既需要深入了解上肢的解剖结构，又需要足够的技能通过多普勒超声检查。本文的目的是回顾动脉和静脉血管树的解剖和血流动力学概念，并解释如何通过超声成像进行血管图绘制，以优化该工具提供的技术资源。同样，将讨论适当的通路创建标准，以最大程度地降低失败和相关并发症的风险。
