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Venous disease has high prevalence, affecting at least a third of the adult population in Western countries. In patients with venous disease, the venous return is impeded as a result of reflux, obstruction, or the combination of both pathologies. Reflux…
Venous thromboembolism (VTE) is a significant national health problem, with approximately 900,000 individuals affected annually. When compared with whites, African Americans have a 40% higher incidence of VTE. Despite improvements in prophylaxis and treatment of VTE, the incidence of this…
Basic Coagulation Pathways Hemostasis is generally initiated by damage to the vessel wall and disruption of the endothelium, but in venous thrombosis (VT), it may be initiated in the absence of vessel wall damage. Both arterial thrombosis and VT converge…
Dialysis access management was traditionally performed in the hospital setting. Now, newly developed percutaneous techniques have allowed some of these procedures to be transitioned to the outpatient office setting. The increased prevalence of diabetes and hypertension in an aging population…
The achievement and maintenance of sites for hemodialysis is a persistent challenge. A hemodialysis access that remains patent and free of infection and complications is critical to ensuring a high standard of care for the patient with end-stage renal disease…
The role of surveillance for permanent hemodialysis arteriovenous access, both autogenous (arteriovenous fistula [AVF]) and prosthetic (arteriovenous graft [AVG]), remains unresolved. Simplistically, clinical monitoring refers to the “examination and evaluation of vascular access by means of physical examination to detect…
The public health burden imposed by end-stage renal disease (ESRD) is significant and has increased in prevalence since the turn of the century. In 2005, the U.S. Renal Data System reported that the prevalent dialysis population was 341,000, having increased…
A major focus of the kidney disease outcomes and quality initiative is the creation of the national vascular access improvement initiative with a “fistula first” campaign. A goal of 66% prevalence of arteriovenous fistulas (AVFs) was suggested for 2009. This…
Central venous access is required for temporary or permanent hemodialysis in many situations. It is estimated that several million central venous catheters (CVCs) are inserted annually in the United States. This widespread use has been accompanied by a concomitant abundance…