title: Complications in Percutaneous Dialysis Interventions: How to Avoid Them, and How to Treat Them When They do Occur.
abstract: Because of the increasing prevalence of end-stage renal disease, more percutaneous interventions are being performed. They serve an important role, allowing for restoration of access function, which is achieved with high level of technical success. However, complications are inevitable during any types of procedure, and percutaneous dialysis interventions are no exception. To provide safe and effective care these patients need, anyone performing endovascular dialysis interventions needs to understand the possible complications, how they can be avoided, and how they can be addressed if they are to occur. Topics in this article include complications seen while intervening on the thrombosed access, complications of angioplasty, potentially devastating complications of central venous interventions, and complications of dialysis catheter placement. Further, patients with end-stage renal disease are generally sicker than the average patient, usually afflicted by multiple comorbidities and are therefore more complicated from a medical perspective. This places them at higher risk for acute cardiopulmonary decompensation or arrest than any other interventional radiology patient subset. As result, we also briefly review general medical complications in this population.
authors.affiliation: Division of Interventional Radiology, Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Medical College, New York, NY. Electronic address: TAF9043@med.cornell.edu.
authors.forename: Tamir
authors.initials: T
authors.lastname: Friedman
authors.affiliation: Vascular & Interventional Radiology Clinic of Jackson, Jackson, TN.
authors.forename: Emilio E
authors.initials: EE
authors.lastname: Lopez
authors.affiliation: Division of Interventional Radiology, Department of Radiology, University of California-San Diego, San Diego, CA.
authors.forename: Keith B
authors.initials: KB
authors.lastname: Quencer
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D061807:Catheter Obstruction / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D057510:Endovascular Procedures / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D010690:Phlebography; D015641:Radiography, Interventional; D006435:Renal Dialysis; D012307:Risk Factors; D016896:Treatment Outcome; D056824:Upper Extremity Deep Vein Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
keywords: Hemodialysis complications; declotting complications; hemodialysis catheter complications; venous rupture