Please use this identifier to cite or link to this item: https://scidar.kg.ac.rs/handle/123456789/8299
Title: Dysfunction of the arteriovenous fistula for hemodialysis as a consequence of venous neointimal hyperplasia and treatment strategies
Authors: Stolic, Radojica
Journal: Srpski Arhiv za Celokupno Lekarstvo
Issue Date: 1-Sep-2019
Abstract: © 2019, Serbia Medical Society. All rights reserved. One of the main problems related to inadequate planning of vascular access is dysfunction during maturation. Arteriovenous fistula dysfunction is most often a consequence of neointimal hyperplasia. Important causes for initial dysfunction of the fistula include narrow lumens of the arteries and veins used for anastomosis, damage to the vascular endothelium during fistula creation, previous venipunc-ture, postoperative development of venous collaterals, the impact force of friction on the arteriovenous anastomosis, a genetic predisposition for development of vascular stenosis, neointimal hyperplasia and previously persistent venous neointimal hyperplasia. Any damage to the endothelium is a stimulus for neointimal hyperplasia. During surgery for creating the fistula, endothelial cells separate on the intima, edema appears, fibrin is deposited, leukocytes and platelets infiltrate. Spotted edema and necrosis of smooth muscle cells appear in the media. In order to determine an adequate therapeutic strategy, the pathogenesis of intimal hyperplasia has been widely considered from different aspects. It is currently based on preoperative preservation of veins and careful selection of blood vessels, percutaneous transluminal angioplasty or surgical revision. Nevertheless, no current therapeutic strategies provide appropriate recommendations to improve maturation of the arteriovenous fistula. Notwithstanding considerable knowledge about the pathogenesis of venous neointimal hyperplasia, currently no prophylactic treatments would reduce its progression.
URI: https://scidar.kg.ac.rs/handle/123456789/8299
Type: Review
DOI: 10.2298/SARH180413020S
ISSN: 03708179
SCOPUS: 85074480623
Appears in Collections:Faculty of Medical Sciences, Kragujevac
[ Google Scholar ]

Page views(s)

21

Downloads(s)

222

Files in This Item:
File Description SizeFormat 
10.2298-SARH180413020S.pdf357.87 kBAdobe PDFThumbnail
View/Open


Items in SCIDAR are protected by copyright, with all rights reserved, unless otherwise indicated.