Hemodialysis Of The Vascular Access Needle For Permanent Vascular Access

Arteriovenous fistula (AVF) is a permanent surgical connection between an artery and a vein that dilates and thickens the wall, tolerating repeated puncture by a puncture needle. Avfs generally take 4-8 weeks to mature, but should be used in advance at least 2-3 weeks later. Complications include the following:

1. Early thrombosis thrombosis is mostly caused by surgical factors, and should be removed as soon as possible. The late stage of thrombolysis may be due to vascular stenosis, hypotension and hypercoagulability, and the thrombolysis effect is not good. Early surgical treatment or prophylactic anticoagulant therapy should be used.

2. Insufficient blood flow is mostly caused by vascular stenosis caused by repeated puncture

3. Sensitive antibiotics must be selected for infection, local incision and drainage or surgical treatment if necessary.

4. Aneurysms and pseudoaneurysms Aneurysms are blood-filling cysts that form when the wall of an artery is stretched and dilated. Pseudoaneurysm is formed by prolonged distention of arterial wall. The difference between pseudoaneurysm and true aneurysm is that it does not have three layers of outer membrane, middle elastic fiber and inner membrane. If this occurs, the aneurysm should be avoided during puncture so as not to cause massive bleeding.

5. Steal syndrome is common in elderly patients and those with arteriosclerosis. It is because the blood supply of the distal limb is shunt through the pathway, so that its blood supply is reduced, limb ischemia and hypoxia. It is manifested as hand pain after activity, cold end, may be complicated by ulcers, distal tissue atrophy, necrosis and so on.

6. The traditional view of loss of internal fistula function is caused by anastomotic stenosis, hemangioma, thrombosis and other factors. New studies have found that abnormal endothelial cell function, abnormal platelet on the migration of arterial smooth muscle cells, abnormal differentiation and other biological characteristics of the changes caused by the loss of intima hyperplasia are also important factors for the loss of internal fistula function.