Nephrologists, radiologists and cardiovascular surgeons collaborate in the control of vascular access, key to treatment
To date, some 340 hemodialysis patients have benefited from a vascular access control program that La Arrixaca launched two years ago. Nephrologists, radiologists and cardiovascular surgeons work on this “pioneering” project, which was presented this Tuesday by its managers to the Minister of Health, Juan José Pedreño.
Vascular accesses are created in order to start hemodialysis treatment. They are constructed by joining the patient’s artery and vein under the skin of the arm. Thanks to this union, the pressure inside the vein increases, due to which the walls are strengthened. Keeping this fistula in good condition is essential to avoid complications and infections, and hence the implementation of this program in La Arrixaca.
Vascular accesses “can have multiple complications: they become stenosed [se estrechan] arteries or veins, there is not enough flow for renal filtration, or the fistula stops working, so temporary accesses have to be made, which are always worse,” explained Juan Cabezuelo, head of the Nephrology service at La Arrixaca. Sometimes it is necessary to switch to more aggressive alternatives, such as central venous catheters. The objective of the program is to anticipate these problems, through surveillance and control of fistulas. The nephrologists are in charge of this follow-up in coordination with the hemodialysis units. If a problem is detected, it can be done through interventional radiology, “with the dilation of the artery or vein”, or through repair surgery.
The Minister of Health, Juan José Pedreño, highlighted the “great work of the three services involved, because by coordinating and cooperating with each other they have managed to eliminate the surgical waiting list for vascular access, have reduced morbidity and mortality and have reduced complications and infections ».
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