The maintenance of arteriovenous (AV) hemodialysis accesses in patients with end-stage kidney disease (ESKD) requires as much thought and consideration as their initial creation in order to individualize patient care and preserve future access options. The ESKD Life-Plan, a key…
Central venous catheters play an important role in the treatment of patients with end-stage renal disease. Despite initiatives to improve fistula creation, more than 80% of patients initiated hemodialysis with a catheter, a number that has changed little over the…
Over the past decade, significant improvements have been made in quality of care and life expectancy for patients on hemodialysis. Consequently, it is not uncommon for the surgeon to be confronted with patients who have “outlived” their arteriovenous (AV) access…
As the population ages and the incidence of diabetes rises, chronic kidney disease (CKD) and end-stage renal disease (ESRD) are increasingly common diagnoses in the United States. In 2017, data from the United States Renal Data System (USRDS) showed that…
The earliest description of an acquired arteriovenous fistula (AVF), the abnormal communication between an artery and vein, is attributed to William Hunter, who in 1761 reported two cases of brachial AVFs following attempted phlebotomy. He also described the adaptive dilation…
Introduction Vascular anomalies comprise a collection of disorders characterized by abnormal, non-neoplastic blood vessel growth. The need for accurate characterization of these lesions has led to the development of a classification system based on biologic behavior which is approved by…
Introduction The proper diagnosis and treatment of vascular anomalies has long been impeded by misused terminology. Advances in our understanding of these disorders led to the creation of a biological classification system, formally adopted by the International Society for the…
Our understanding of why some children are born with imperfections while the majority are born with normal anatomy has made a tremendous improvement through the last half century. These often disfiguring anomalies are commonly seen by both general practitioners and…
Introduction The lymphatic system is the least understood part of the vascular system. Lymphatic malformations such as chylous disorders, cystic hygromas, and lymphocysts are rare; acquired disorders such as lymphoceles and chylous effusions are also uncommon. However, local interruption and…
Introduction In this chapter, we examine the lymphatic system ( Fig. 168.1 ) and its malfunction with a focus on current nonoperative treatments. The diagnosis and surgical treatment of lymphedema are discussed in other chapters. It is important to know…