English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Increasing age and comorbidities as well as the duration of chronic dialysis make it difficult to establish and maintain a functioning vascular access in patients with terminal kidney failure. The risk of a central venous stenosis or occlusion is greatly increased with a central venous catheter and cardiological or oncological interventions. The implantation of the Hemodialysis Reliable Outflow (HeRO®) graft (Merit Medical Systems Inc., South Jordan, UT, USA) is meanwhile an established combined interventional/surgical procedure for restoration of the stenosed or occluded venous outflow. In this way the vascular access in the upper extremity can be preserved and the important vascular resource of the lower extremity can be spared. In our center a total of 73 successful implantations have been carried out since 2013. The demand is increasing. With growing clinical experience, the surgical intervention has become an established low risk procedure. According to our clinical experiences, after an implantation a reintervention for acute thrombosis is necessary 2-3 times per year. With appropriate experience revision interventions are usually technically easy to carry out. In cases of complete occlusion of the central venous circulation in the region of the superior vena cava, which cannot be passed by the HeRO® graft, a combined intervention with the Surfacer® System (inside-out procedure) is possible and meaningful. When necessary, the HeRO® graft can also be used with an early cannulation graft in order to avoid a temporary dialysis catheter. Despite the increasing numbers of HeRO® graft implantations, this option remains a reserve procedure in our center. The interventional procedures without implantation of foreign material should first be attempted and established vascular surgical alternatives, such as an internal jugular vein graft should be given priority.

HeRO®-Graft: technische Anwendung und eigene klinische Erfahrung in 73 Fällen