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Vol. 33. Núm. 4.Julio 2013
Páginas 443-622
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Vol. 33. Núm. 4.Julio 2013
Páginas 443-622
DOI: 10.3265/Nefrologia.pre2013.Feb.11725
Acceso a texto completo
Costos y resultados del tratamiento endovascular de las trombosis en las fístulas autólogas para hemodiálisis
Costs and outcomes of endovascular treatment of thrombosed dialysis autogenous fistulae
Visitas
6228
Luis Coentraoa
a Nephrology Research and Development Unit, Sao Joao Hospital Centre, Porto, Portugal,
Este artículo ha recibido
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Visitas
Información del artículo

El acceso vascular funcional es un requisito previo para el tratamiento renal sustitutivo en pacientes con enfermedad renal crónica. Las fístulas autólogas se consideran superiores a las prótesis vasculares y los catéteres venosos centrales; sin embargo, las fístulas no están exentas de problemas. Las trombosis de la fístula autóloga se han convertido en un reto en la práctica clínica de nefrología, con importantes implicaciones clínicas para pacientes en diálisis. Varios estudios han informado sobre la viabilidad y la tasa relativamente alta del éxito clínico del abordaje endovascular de fístulas trombosadas en los últimos años. Sin embargo, como las repetidas intervenciones suelen ser necesarias para lograr la supervivencia a largo plazo del acceso, el mantenimiento de una fístula anteriormente trombosada podría ser una política muy cara. Los objetivos de este artículo son proporcionar al lector una idea de los múltiples enfoques endovasculares para fístulas autólogas trombosadas, teniendo en cuenta su eficacia clínica y las implicaciones financieras.

Palabras clave:
Análisis de costo
Palabras clave:
Análisis económico
Palabras clave:
Fístula arteriovenosa autóloga
Palabras clave:
Trombectomía percutánea
Palabras clave:
Diálisis
Palabras clave:
Tratamiento endovascular

Functional vascular access is a prerequisite for adequate haemodialysis treatment in patients with end-stage renal disease. Autogenous arteriovenous fistulae are considered superior to synthetic grafts and central venous catheters; however, fistulae are not without problems. Fistulae thrombosis has become a clinical challenge in nephrology practice, with relevant clinical implications for dialysis patients. Several studies have reported on the feasibility and relatively high-clinical success rate of the endovascular approach to thrombosed fistulae in recent years. However, as repeated interventions are usually required to achieve long-term access survival, maintenance of a previously thrombosed fistulae could be a highly expensive policy. The goals of this article are to provide the reader an insight into the multiple endovascular approaches for thrombosed arteriovenous fistulae, bearing in mind its clinical effectiveness and financial implications.

Keywords:
Cost analysis
Keywords:
Economic analysis
Keywords:
Autogenous arteriovenous fistulae
Keywords:
Percutaneous thrombectomy
Keywords:
Dialysis
Keywords:
Endovascular treatment
El Texto completo está disponible en PDF
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