Resumo

GALLEGUILLOS O, IVÁN et al. Symptomatic ischemia of hemodialysis vascular access. Rev Chil Cir [online]. 2007, vol.59, n.5, pp. 348-352. ISSN 0718-4026.  doi: 10.4067/S0718-40262007000500007.

Background: Symptomatic ischemia occurs in 1 to 8% of hemodialysis vascular accesses and may result in its loss. Aim: To report our experience in the management of patients with severe symptomatic ischemia associated to a vascular access for hemodialysis. Material and methods: All patients operated for a severe ischemia associated to a hemodialysis vascular access, between 2000 and 2005, were included in this study. Results: Of a total of 1926 vascular accesses, symptomatic ischemia was diagnosed in 18 patients (9 males) aged between 27 and 84 years. Fourteen (78%) were diabetic. Thus, the incidence of severe ischemia was 1.2%. It appeared in 1.1% of native and 1.9% of prosthetic vascular accesses. Clinical manifestations appeared in the early postoperative period in seven patients (39%). In the rest, they appeared more than 30 days after the procedure. Surgical treatment consisted in revascularization in eight patients (45%) and closure of fistula and installation of a tunneled catheter in 10 (55%). At the end of follow up, 15 patients (83%) had a complete regression of symptoms and three (17%) had sequelae. Conclusions: Symptomatic vascular access ischemia occurs in 1.2% of procedures, is much more common among diabetics and can be successfully managed in 80% of cases

Palavras-chave : Hemodialysis; vascular access; ischemia.