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Within North America, devices used for on-label indications represent that the corresponding government health authorities recognize the device as designed and tested for the indications on the label or indications for use (IFU). For stents indicated for vascular use, the stent would have been tested for fatigability, crush resistance, and flexibility. For example, most stents are tested for a minimum...
Central venous stenosis (CVS) and occlusions in the hemodialysis patient are unique clinical problems that arise mainly from previous central venous catheter insertions, particularly from the subclavian vein approach and left-sided approaches [1–4]. As a result of this observation, K/DOQI recommends placement of more permanent venous access and avoiding catheter-based dialysis when possible [5]. Insertion...
As in dialysis grafts, the underlying cause of failures or thromboses in functional dialysis fistulas is most often venous stenosis. Primary percutaneous treatment remains POBA. Management of dysfunctional autogenous fistulas presents a number of challenges not encountered with arteriovenous grafts. Attempts at percutaneous intervention require substantially more effort and time, which is often rewarded...
The cephalic arch represents the portion of the cephalic vein in the shoulder as it traverses the deltopectoral groove, through the clavipectoral fascia, and passes below the clavicle and joins the axillary vein. Occasionally, an accessory cephalic arch is present. Rarely, the cephalic arch empties into the internal or external jugular vein. This area has a particular propensity for stenosis: the...
One should not assume that percutaneous interventions within hemodialysis accesses are routine and simple. While a dominant majority of interventions are low risk, complications are inevitable when one has performed a sufficient number of cases. While many of the potential complications can be managed with endovascular techniques, others are true surgical emergencies and should be recognized as such...
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