Kết thúc xa của hệ thống trao đổi fresenius povidone-iodine gel có chứa ® Safe-Lock. H) Lưu ý các kẹp vuông mở (DC) (Del kẹp đóng cửa) gần ® Safe-Lock. I) Sau khi hoàn tất trao đổi này Del kẹp khóa, và phần dự phòng của ống (SNAP) (Snap ™ Ngắt kết nối) nắm và J) bị phá vỡ | Dialysis Technique and Access Management 293 Fig. . G The distal end of the Fresenius exchange system is povidone-iodine gel containing Safe-Lock . H Note the open square clamp DC Del-Clamp closure just proximal to the Safe-Lock . I At the completion of the exchange this Del-Clamp is locked and the redundant section of tubing SNAP Snap Disconnect grasped and J And broken leaving the povidone-iodine Safe-Lock connector attached to the catheter adaptor. 9 Chapter 10 Tools and Methods for Vascular Access Surveillance Aamer ArRajab and Mitchell Henry Introduction This chapter presents an overview of current available tests for preoperative evaluation as well as surveillance methods for vascular access. All of these interventions are designed to improve the longevity of dialysis access and reduce access failures. More than 300 000 patients are treated for chronic renal failure yearly. While about 5 of them will undergo renal transplantation each year dialysis remains the only option for the majority. Because of the continuously increasing number of patients on hemodialysis vascular access surgery has become part of the daily work of many surgeons. The main complication of all types of vascular access is thrombosis. Many centers report one and three year patency rates of arteriovenous AV grafts of 60 and 20 respectively. Fifteen percent of hospitalizations of patients with end-stage renal disease are caused by vascular access complications. This makes it a major cost as well as a health issue. Accordingly a significant number of dialysis patients run out of sites for access. Measures to improve the longevity of vascular accesses are needed. Preoperative evaluation to select the most appropriate site and type of access could play a role. Access surveillance to predict and prevent access failure and consequently to correct the lesion is likely to prevent access thrombosis or loss. Preoperative Evaluation Duplex Doppler Most centers do not routinely use radiologic .
