OBJECTIVES: Vascular access (VA) stenoses play a significant role in the morbidity of the haemodialysed population. Classifications for diagnosis, assessment and proposal of treatment strategies can be useful clinical and methodological tools. This review aims to present a comprehensive summary and propose further methodological approaches. DESIGN: A systematic review of the literature, evaluating classifications for dialysis-related VA stenosis. DATA SOURCES: Web of Science, Scopus, PubMed, Google Scholar and the ClinicalTrials.gov registry were searched from inception to 7 December 2024. ELIGIBILITY CRITERIA: All articles containing classifications regarding dialysis VA were eligible, with no restrictions on the study type or language of the full text. DATA EXTRACTION AND SYNTHESIS: Two independent researchers performed the search and initial screening. Four vascular surgeons assessed the included classifications using a modified Buchbinder's critical appraisal tool to evaluate quality. RESULTS: From 4771 screened papers, 59 full-text papers were retrieved and 24 articles contained classifications. Three classifications were dedicated to VA stenosis, all based on the anatomical location of lesions. According to the modified Buchbinder's appraisal, the classifications were assessed as moderate-to-good quality. The literature disposes of immense inconsistency in terms of the definition of significant stenosis indicated for treatment. CONCLUSIONS: VA significant stenosis and its classification is a non-uniformly understood issue with many different criteria and categorisations. This basic methodological problem leads to inconsistent results. We recommend the unification of the criteria and their validation in prospective studies.

• Klíčová slova
• Cardiovascular Disease, Dialysis, End stage renal failure, Vascular medicine, Vascular surgery,
• MeSH
• arteriovenózní zkrat * škodlivé účinky   MeSH
• cévní přístupy * škodlivé účinky   MeSH
• dialýza ledvin * škodlivé účinky   MeSH
• lidé MeSH
• stenóza klasifikace   etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• scoping review MeSH

BACKROUND: The use of arteriovenous graft is indicated in patients if the subcutaneous venous bed is exhausted or unsuitable for arteriovenous fistula creation. The leading cause of failure of a prosthetic arteriovenous hemodialysis-access graft is venous anastomotic stenosis causing thrombosis of the graft. A number of surgical techniques and endovascular tools have been used to treat this stenosis and thrombosis. None have yet proven to be ideal. This study was designed to evaluate the results of hybrid treatment of arteriovenous graft thrombosis associated with venous anastomotic stenosis. METHODS: Over the period 2013-2014, we treated 16 AVG occlusions. Immediately after the diagnosis of occlusion was made, the patients underwent thrombectomy using a Fogarty catheter. After thrombectomy, a diagnostic fistulogram was performed and if VAG stenosis was confirmed, it was treated with balloon angioplasty and stent graft introduction. Lesions were dilated to reduce the stenosis in the treated area to less than 25%. RESULTS: Primary patency after 12 months was 32.8%. Primary assisted patency was 44.7%, secondary patency was 47.6%. Restenosis of the stent graft was seen in two patients. Recurring AVG occlusion was observed in four patients. The average number of interventions to maintain AVG patency was 1.18 per patient/1 year of dialysis. CONCLUSION: Treatment of AVG thrombosis due to VAG stenosis by hybrid procedure proved to be effective and improved secondary patency.

• Klíčová slova
• AVG thrombosis, arteriovenous graft for hemodialysis (AVG), stent graft, surgical thrombectomy, venous anastomotic stenosis (VAG),
• MeSH
• cévní přístupy škodlivé účinky   MeSH
• dialýza ledvin * MeSH
• lidé MeSH
• magnetická rezonanční angiografie MeSH
• okluze cévního štěpu chirurgie   MeSH
• přežívání štěpu MeSH
• průchodnost cév MeSH
• stenty MeSH
• trombektomie metody   MeSH
• trombóza chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Central venous catheter (CVC)-related problems, risks and safety hazards are partly caused by different characteristics of the CVC-based access and their performance features. This chapter covers those issues in a chronological order, from factors related to the choice of the CVC, insertion site and insertion procedure itself, over those associated with CVC use and their monitoring up to safety hazards of interventional procedures. Not discussed are CVC infections as they are covered in a separate chapter in this book.

• MeSH
• bezpečnost pacientů * MeSH
• cévní přístupy škodlivé účinky   klasifikace   MeSH
• chronická renální insuficience terapie   MeSH
• design vybavení MeSH
• dialýza ledvin škodlivé účinky   přístrojové vybavení   metody   MeSH
• dodržování směrnic MeSH
• kontrola infekce MeSH
• lidé MeSH
• průchodnost cév fyziologie   MeSH
• rizikové faktory MeSH
• trombóza epidemiologie   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

More than 50% of all end-stage renal disease (ESRD) patients die from cardiovascular complications. Among them, heart failure and pulmonary hypertension play a major role, and published studies document significantly higher mortality rates in patients with these two states. Arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) are the preferred types of vascular access (VA). However, both AVF and AVG increase cardiac output and in turn could contribute to (the decompensation of) heart failure or pulmonary hypertension. No really safe access flow volume exists, and the ESRD patients' reactions to it vary considerably. We review the mechanisms involved in the cardiovascular consequences of increased cardiac output and available literary data. The link between access flow volume and increased mortality due to pulmonary hypertension or heart failure probably exists, but still has not been directly evidenced. Regular echocardiography is advisable especially in patients with symptoms or with high VA flow (>1,500 ml/min).

• MeSH
• arteriovenózní zkrat škodlivé účinky   MeSH
• bezpečnost pacientů * MeSH
• cévní přístupy škodlivé účinky   MeSH
• chronické selhání ledvin terapie   MeSH
• dialýza ledvin škodlivé účinky   MeSH
• echokardiografie MeSH
• hemodynamika fyziologie   MeSH
• lidé MeSH
• minutový srdeční výdej fyziologie   MeSH
• plicní hypertenze etiologie   patofyziologie   prevence a kontrola   MeSH
• srdeční selhání etiologie   patofyziologie   prevence a kontrola   MeSH
• údržba MeSH
• výkony cévní chirurgie škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• cévní přístupy škodlivé účinky   MeSH
• dialýza ledvin škodlivé účinky   přístrojové vybavení   metody   MeSH
• kongresy jako téma MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• bolesti na hrudi diagnostické zobrazování   etiologie   MeSH
• cévní přístupy škodlivé účinky   MeSH
• cizí tělesa komplikace   diagnostické zobrazování   chirurgie   MeSH
• dospělí MeSH
• hrudní chirurgie video-asistovaná MeSH
• katetrizace centrálních vén škodlivé účinky   přístrojové vybavení   MeSH
• lidé MeSH
• odstranění implantátu metody   MeSH
• počítačová rentgenová tomografie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH