Subject Index

Acute catheters, see Temporary catheters Allen-Brown shunt 4, 47 Angiotensin-converting enzyme inhibitors, arteriovenous graft patency effects 84 Arteriovenous fistula advantages in vascular access 32, 33 anastomosis techniques mid-forearm radiocephalic arteriovenous fistula 54 radiocephalic wrist arteriovenous fistula 5154 snuff-box arteriovenous fistula 54 ulnar-basilic arteriovenous fistula 54 upper arm fistulas 5456 aneurysm 202 cardiac overload, risks and prevention 204, 205 chest loop access 69, 70 delayed maturation causes 200 correction 201 maturation enhancement procedures 5658 prevention 201, 202 high-flux hemodialysis access 9, 10 historical perspective for vascular access 3, 4, 11, 47 increasing use strategies 3335 infection 205, 206 ischemic monomelic neuropathy 204 lower limb techniques 6669 morbidity and mortality 19 peripheral ischemia 203, 204

planning and site selection 48, 49 prevalence of use for vascular access 1618, 73, 74 steal syndrome 203 stenosis balloon dilatation complications 314, 315 contraindications 309 patency outcomes 315, 316 patient evaluation 308, 309 technique 309314 fistulagraphy 287, 288 localization 195 overview 194 stenting 199, 200, 292 surveillance 286, 287 treatment overview 196, 197 stenting 10 surveillance and monitoring 36, 37 survival and predictors for vascular access 1924 thrombosis overview 194 percutaneous recanalization complications 318 overview 198, 199, 316 patency outcomes 319 patient selection 295, 296 technique 317, 318 thrombectomy 197 thrombolytic use 3739 upper limb procedures, overview 49, 50, 285, 286

463

Arteriovenous graft aneurysm 202 configurations 62, 63 femoral vein grafts 79 infection and salvage 82, 206 lower extremity sites 75, 76 mesenteric bovine vein graft utilization 6, 7, 61, 62 morbidity and mortality 19 pharmacologic approaches for intimal hyperplasia prevention 8385 predictors of outcome and salvage 82, 83 prevalence of use for vascular access 1618, 73, 74 saphenous vein grafts historical use as grafts 4, 6, 58 homologous great saphenous veins 60, 61 immune response 60 patency rates 59, 79 sheep collagen prosthesis 61 stenosis balloon dilatation complications 292294 contraindications 289 patient evaluation 288 technique 289292 fistulagraphy 287, 288 localization 195 overview 194 stenting 199, 200, 292 surveillance 286, 287 treatment overview 197, 198 surveillance and monitoring 36, 37 survival and predictors for vascular access 1924 synthetic grafts, see Polytetrafluoroethylene grafts; Polyurethane grafts techniques jump grafts 79 overview 6265, 286 stapled anastomosis and vascular clip systems 81, 82 stent repair 81 thrombosis aspiration thrombectomy 301

mechanical thrombectomy 300, 301 overview 194 percutaneous recanalization angioplasty 301, 302 clot removal 298, 299 complications 303307 dislodgement and maceration of arterial plug 302, 303 lyse and wait technique 299, 300 overview 198, 199, 295 patency outcomes 307, 308 patient selection 295, 296 technique 297, 298 thrombolytic use 3739, 296, 298, 299 thrombectomy 197, 295 upper extremity sites 75 vascular steal 81 Ash Split Cath clinical experience and studies comparative studies 143146 overview 139143 design 132, 135 flow rates 141, 142 placement 140 removal 141 Aspirin, arteriovenous graft patency effects 84, 85 AVF, see Arteriovenous fistula AVG, see Arteriovenous graft Bernoullis equation 239 Blood Temperature Monitor vascular access blood flow measurement 272, 273 vascular access recirculation measurement 264, 265 BTM, see Blood Temperature Monitor Buselmeier shunt 4, 47 Calcium channel blockers, arteriovenous graft patency effects 83, 84 Canaud catheter, features 131, 132 Cannon catheter, features 136 Carbon transcutaneous access device, historical perspective 9

Subject Index

464

Chronic central venous catheters, see also Ash Split Cath; Hemodialysis catheters; Opti-Flow catheter; Tesio catheter central vein pressure considerations 125, 128, 129 complications infection management 208, 209 pathogens 208 prevention 209 placement-related complications 207, 208 rates compared with arteriovenous fistulas and grafts 146 thrombosis intrinsic thrombi 210 mural thrombi 209, 210 prevention 211 treatment 210, 211 components 131, 133 cuffs 129, 130 design requirements bondability 137 chemical resistance 138 clamping and expansion 138 conformance to body shape 137, 138 crimping resistance 137 flexibility 137 moldability 137 radiopacity 138 rigidity 137 strength 137 thickness 136 history of designs and types 131136 materials 138, 139 over-the-wire technique for placement 147150 placement 130, 131 prospects for improvement 150, 151 successful function features 131 Clinical practice guidelines, vascular access, see also Kidney Disease Outcomes Quality Initiative development 29, 30 fibrinolytic therapy for occlusion 39 major issues 30, 31

thrombolytic use catheter-based devices 38, 39 grafts and fistulas 37, 38 Clopidogrel, arteriovenous graft patency effects 85 Continuous flow peritoneal dialysis, see Peritoneal dialysis catheters Continuous quality improvement, vascular access care global differences in vascular access 331, 332 overview 323325 quality cost continuum 330, 331 quality management theory continuous quality improvement process 328 principles 325, 326 quality assurance 327, 328 Six Sigma quality concept 329, 330 total quality management 326, 327 quality programs predialysis vascular access quality program 333335 selection 332, 333 surveillance data and statistical models 335337 vascular access care program access flow monitoring and outcomes 341344 implementation phases 341 infection control 344 outcome 338 problem identification 339, 340 process 338 prospects 344, 345 quality metrics 341 team 337339 CQI, see Continuous quality improvement Crit-Line monitor, vascular access recirculation measurement 260, 261 CTAD, see Carbon transcutaneous access device Databases, development for vascular access problems 40 Dialock System clinical studies 186, 187

Subject Index

465

Dialock System (continued) complications care and maintenance-related complications 188, 189 insertion-related complications 187, 188 features 180, 182 placement 182184 Dialysance conductivity, vascular access blood flow measurement 223, 224, 273 Dialysis Outcomes and Practice Patterns Study overview 14, 15 vascular access use mode comparison internationally 15, 16, 94, 178, 207, 332, 350, 376 Dipyridamole, arteriovenous graft patency effects 84, 85 Doppler ultrasound, vascular access blood flow measurement 224, 269, 274 DOPPS, see Dialysis Outcomes and Practice Patterns Study Double-lumen catheters, see also Temporary catheters historical perspective 7, 8 peritoneal dialysis, see Peritoneal dialysis catheters Economics catheters 33 quality cost continuum 330, 331 United States vascular access costs 29 vascular access utilization type cost issues 24, 25 Epidemiology, vascular access utilization cost issues 24, 25 Dialysis Outcomes and Practice Patterns Study overview 14, 15 vascular access use comparison internationally 15, 16, 94, 178, 207, 332, 350, 376 morbidity and mortality by type 19 predictors of initial vascular access types age 17 dedicated surgeon effect 19 diabetes 17

dialysis facility preference 18 duration of predialysis care 18 peripheral vascular disease 17 physician type 18 preoperative sonographic mapping 18, 19 race 17 sex 16, 17 survival country differences 21 factors affecting age 20 blood flow rate practices 24 complications 21 monitoring policy 23 multidisciplinary approach 22, 23 pharmacological prophylaxis 24 preoperative sonographic mapping 22 prior vascular access 22 race 21 sex 20, 21 site of vascular access 21, 22 surgeon experience 23 timing of first cannulation 23, 24 fistulas versus grafts 1922 United States practices 16, 73, 74 Femoral vein, temporary cannulation 97 Glucose dilution, vascular access recirculation measurement 262 Glucose pump test, vascular access blood flow measurement 275 Hemasite, historical perspective 9 Hematocrit, vascular access blood flow measurement hematocrit dilution 222, 223 principles 228 TQA method 232234, 236 ultrafiltration method 229232 Hemodialysis catheters, see Hemodialysis catheters historical perspective 14, 9, 10 Hemodialysis catheters, see also Ash Split Cath; Chronic central venous catheters;

Subject Index

466

Double-lumen catheters; Temporary catheters acute versus chronic hemodialysis catheters 116118, 125, 129 blood flow and resistance calculations 122, 123 central vein pressure considerations 125, 128, 129 clamps 115, 116 coatings 124, 125 components 112 cuff designs 116 curved lumen catheter types 116 design development process 118120 extension tubes 115 french size 121, 122 hub, fixed versus removable 114, 115 luers 115 lumen configurations 112, 118 manufacturing process 120121, 125, 126 material selection 123, 124 peritoneal dialysis, see Peritoneal dialysis catheters side hole configurations 114, 129 split tips 114 staggering of tips 112, 114 sterilization 125 suture wings 115 tip geometry 114 Hemodialysis Monitor, vascular access recirculation measurement 260, 261 Hemodynamic Monitor, access blood flow measurement 223 Hemodynamics, hemodialysis access dilatation in access vascular circuit 243 flow changes during hemodialysis 249251 fluid mechanics 238242 graft vascular circuit model pressure change modeling 243245 quantitative predictions of model 244246, 248 mean arterial pressure changes during hemodialysis 249, 251 resistance changes during hemodialysis 249 segment modeling 244

steal syndrome prevention 251 HemoSplit catheter, features 136 Infection arteriovenous fistulas 205, 206 arteriovenous grafts 82, 206 hemodialysis catheters management 208, 209 pathogens 208 prevention 209 temporary catheters double-lumen venous catheters 170174 postprocedural check guidelines 106, 107 risks 94, 95, 101, 102 peritoneal dialysis catheters acute infection management 429, 430 appearance classification 427, 428 chronic infection management 430 design in minimization 391 equivocal exit management 431 external cuff infection management 431 fungal infection 437, 438 prevention 422, 423, 432 removal and replacement of catheter 436438 Staphylococcus aureus nasal carriage 426, 427, 432, 436 vascular access care program 344 Jugular vein access catheters 8 temporary cannulation 98, 100 K/DOQI, see Kidney Disease Outcomes Quality Initiative Kidney Disease Outcomes Quality Initiative arteriovenous fistula recommendations 33, 48, 73, 178, 285 blood flow rate requirements for hemodialysis 31, 32 overview 29, 30 temporary catheter guidelines 9597, 100102, 105107

Subject Index

467

Kidney Disease Outcomes Quality Initiative (continued) thrombolytic use catheter-based devices 38, 39 grafts and fistulas 37, 38 vascular access guidelines 30, 323, 351, 352 LifeSite System clinical studies 185, 186, 211, 212 complications care and maintenance-related complications 188, 189 insertion-related complications 187, 188 features 180182 placement 182184 Mahurkar catheter, features 132 Mesenteric bovine vein, graft utilization 6, 7, 61, 62 Multimat sensor, vascular access recirculation measurement 261, 262 Nasal carriage, Staphylococcus aureus 426, 427, 432, 436 Opti-Flow catheter comparative studies with other chronic central venous catheters 143146 design 132 Patient perspective, vascular access access preservation 369 aseptic preparation 367 communication information access 372, 373 patients 372 staff 371, 372 importance 363, 364 Medicare reimbursement 365 pain 370, 371 personal commentaries 364, 367371 recommendations 373, 374 self-cannulation 366, 368, 369, 371 standardized access care information 368

technician preferences for grafts 368, 369 temporary catheters 368 vascular surgeon differences 364, 365, 368 Percutaneous intervention, see Stenosis; Thrombosis Peritoneal dialysis catheters, see also Swan-neck catheters; Tenckhoff catheter bowel perforation 439, 440 break-in period 410, 411 continuous flow peritoneal dialysis adequacy targets 447 advantages 448, 449 double-lumen catheters care 454, 455 clinical studies 458460 insertion 453, 454 overview 393, 394 peritoneal trauma and discomfort reduction 449, 450 recirculation reduction 450, 451, 453 requirements 449 testing in vitro 455457 peritoneal access options 448 cuff extrusion management 416418 drainage time and breakpoint determination 419, 420 exit site care appearance and healing 423, 424, 427, 428 bacterial colonization of catheter sinus 426, 437 early care 424, 425 infection acute infection management 429, 430 appearance classification 427, 428 chronic infection management 430 equivocal exit management 431 external cuff infection management 431 fungal infection 437, 438 prevention 422, 423, 432 removal and replacement of catheter 436438

Subject Index

468

Staphylococcus aureus nasal carriage 426, 427, 432, 436 long-term care 428433 morphology of healed catheter tunnel 425, 426 prophylactic antibiotics 425 traumatized exit management 432 historical perspective 387390, 402 insertion blind insertion 404, 405 comparison of techniques 408 general guidelines 403, 404 Moncrief-Popovich technique 406, 407 peritoneoscopic implantation 405 preimplantation care 402, 403 surgical insertion 405 integrity preservation rules 411, 412 obstruction management causes 441, 443 one-way obstruction 414, 415 rules 412, 413 two-way obstruction 413, 414 pericatheter leakage management 418, 438, 439 peritoneal loss of function 441 pleuroperitoneal communication 440, 441 rare complications 444 removal 415, 436438 rupture management 415, 443 sclerosant peritonitis 444 transcutaneous trauma prevention during abdominal medication injection 415, 416 PermCath, features 132 Poisseuilles law 240, 242, 243 Polytetrafluoroethylene grafts cuffed grafts 78 history of use 6, 10, 11, 76 modifications for grafting 59, 76, 78 patency 35, 36, 59, 60 Polyurethane grafts patency rates 78, 79 self-sealing grafts 78, 79 PTFE grafts, see Polytetrafluoroethylene grafts

QA, see Quality assurance Quality assurance, vascular access care global differences in vascular access 331, 332 overview 323325 quality management theory 325328 quality programs predialysis vascular access quality program 333335 selection 332, 333 surveillance data and statistical models 335337 vascular access care program access flow monitoring and outcomes 341344 implementation phases 341 infection control 344 outcome 338 problem identification 339, 340 process 338 prospects 344, 345 quality metrics 341 team 337339 Ramirez shunt 4, 47 Reynolds number, definition 241 Saphenous vein grafts historical use 4, 6, 58, 79 homologous great saphenous veins as grafts 60, 61 patency rates 59, 79 SchonCath, features 135, 136 SCIP, see Slow continuous intravenous plasma filtration Scribner arteriovenous shunt, historical perspective 1, 2, 4 Self-cannulation, patient perspective 366, 368, 369, 371 Shear rate, definition 239, 240 Shear stress definition 240 dilatation in access vascular circuit 243 Single-needle dialysis, historical perspective 7

Subject Index

469

Slow continuous intravenous plasma filtration in vitro test results 379383 principles 377 prospects 384, 385 slow continuous ultrafiltration equivalence 377, 378 Split Cath, see Ash Split Cath Steal syndrome arteriovenous fistula 203 arteriovenous graft 81 prevention 251 Stenosis arteriovenous fistulas balloon dilatation complications 314, 315 contraindications 309 patency outcomes 3315, 316 patient evaluation 308, 309 technique 309314 fistulagraphy 287, 288 localization 195 overview 194 stenting 199, 200, 292 surveillance 286, 287 treatment overview 196, 197 arteriovenous grafts balloon dilatation complications 292294 contraindications 289 patient evaluation 288 technique 289292 fistulagraphy 287, 288 localization 195 overview 194 stenting 199, 200, 292 surveillance 286, 287 treatment overview 197, 198 total resistance equations 241, 242 Subclavian vein, temporary cannulation 97, 98 Subcutaneous devices, see Totally subcutaneous hemodialysis access devices Swan-neck catheters, see also Peritoneal dialysis catheters

abdominal catheters Missouri catheters 396, 397 Moncrief-Popovich catheter 397 Tenckhoff catheters 396 design 394, 395 presternal catheter 397, 398 Systemic barriers, vascular access care 250360 Temporary catheters antimicrobial treatment of exit site 107 cannulation sites femoral vein 97 internal jugular vein 98, 100 subclavian vein 97, 98 double-lumen venous catheters blood flow 174, 175 care and maintenance 175, 176 complications immediate 164, 165 long-term 165 overview 163 ideal criteria 159, 160 infection 170174 insertion 160, 161, 176 materials 160, 161 positioning 161, 163 prevalence of use 159 recirculation 175 thrombosis extrinsic 167 intrinsic 168 overview 166, 167 prevention 168, 169 treatment 169, 170 geometry and tip design 103105 indications acute renal failure 95, 96 peritoneal dialysis failure 96 infection postprocedural check guidelines 106, 107 risks 94, 95, 101, 102 length optimization 105 locking solutions 107, 108 materials and coatings 105, 106 patient perspective 368

Subject Index

470

tunneled cuffed catheter indications and outcomes 100102 Tenckhoff catheter, see also Peritoneal dialysis catheters; Swan-neck catheters coiled catheters 394 complications and modifications for mitigation exit infection 391 external cuff extrusion 393 obstruction 391, 392 pericatheter leak 392 pressure pain 392, 393 development 390 straight catheters 393 Tesio catheter comparative studies with other chronic central venous catheters 143146 complication minimization 157 design 131, 132, 154 materials 154 placement 153155 Thomas shunt 4 Thrombosis access blood flow measurement 220222 arteriovenous fistulas overview 194 percutaneous recanalization complications 318 overview 198, 199, 316 patency outcomes 319 patient selection 295, 296 technique 317, 318 thrombectomy 197 thrombolytic use 3739 arteriovenous grafts aspiration thrombectomy 301 mechanical thrombectomy 300, 301 overview 194 percutaneous recanalization angioplasty 301, 302 clot removal 298, 299 complications 303307 dislodgement and maceration of arterial plug 302, 303 lyse and wait technique 299, 300 overview 198, 199, 295

patency outcomes 307, 308 patient selection 295, 296 technique 297, 298 thrombolytic use 3739, 296, 298, 299 thrombectomy 197, 295 chronic central venous catheter thrombosis intrinsic thrombi 210 mural thrombi 209, 210 prevention 211 treatment 210, 211 risk factors 225 temporary catheters extrinsic thrombi 167 intrinsic thrombi 168 overview 166, 167 prevention 168, 169 treatment 169, 170 Totally subcutaneous hemodialysis access devices clinical studies Dialock System 186, 187 LifeSite System 185, 186, 211, 212 complications care and maintenance-related complications 188, 189 insertion-related complications 187, 188 device features Dialock System 180, 182 Hemaport 190 LifeSite System 180182 history of development 179, 180 placement 182184 prospects 190, 191 rationale 179 TQA method, vascular access blood flow measurement 232234, 236, 270, 274, 281 Uldall catheter, features 132 Ultrafiltration step change method, vascular access blood flow measurement 273, 274 Ultrasound dilution, vascular access blood flow measurement 219222, 271, 272

Subject Index

471

Urea vascular access blood flow measurementa 274 vascular access recirculation measurement 262264 VACP, see Vascular access care program Vascular access care program access flow monitoring and outcomes 341344 implementation phases 341 infection control 344 outcome 338 problem identification 339, 340 process 338 prospects 344, 345 quality metrics 341 systemic barriers to vascular access care 250360 team 337339 Vascular access blood flow measurement accuracy factors indicator introduction effects 277, 270, 280 indicator loss 280, 281 indicator mixing with access flow between introduction and recording sites 275, 276 line reversal effects 277279 second pass of indicator 276, 277 Blood Temperature Monitor 272, 273 dialysance conductivity 223, 224, 273 differential conductivity monitor 272 Doppler ultrasound 224, 269, 274 duplex ultrasound 219 glucose pump test 275 hematocrit-based methods hematocrit dilution 222, 223 principles 228 TQA method 232234, 236, 270, 274, 281 ultrafiltration method 229232

hematocrit dilution 222, 223 Hemodynamic Monitor 223 reversed-line position techniques 269274 thermodilution 272, 273 ultrafiltration step change method 273, 274 ultrasound dilution 219222, 271, 272 urea method 274 Vascular access recirculation clinical implications 265, 266 components access recirculation 255, 256 cardiopulmonary recirculation 257, 258 forced recirculation 257 local recirculation 255 definition 255 measurement Blood Temperature Monitor 264, 265 bolus techniques 259, 260 Crit-Line monitor 260, 261 glucose dilution 262 Hemodialysis Monitor 260 Hemodynamic Monitor 261 Multimat sensor 261, 262 overview 224, 225, 258, 259 temperature 260 thermodilution 264 urea technique 262264 Vascular access team development and organization 40 importance in vascular access survival 22, 23 prevention of complications 212 Vascular endothelial growth factor, arteriovenous graft patency effects 85 VEGF, see Vascular endothelial growth factor Venous pressure, measurement in vascular access monitoring 217219 Viscosity, definition 240

Subject Index

472