Ecografía y catéter fístula: una estrategia para reducir lesiones en el acceso vascular

Abstract

The use of ultrasound has been shown to improve knowledge of vascular access, facilitating the choice of puncture sites and increasing confidence in difficult punctures. With the aging of the hemodialysis population, vascular deterioration complicates access to the native arteriovenous fistula, thus increasing the risk of complications such as hematomas, thrombosis, and stenosis. These difficulties can lead to the use of central venous catheters, increasing morbidity and mortality.
Conventional metal needles can damage the native arteriovenous fistula, reducing its longevity. As an alternative, the fistula catheter minimizes vascular damage by reducing the risk of extravasations and hematomas. This study compared both types of needles in 12 patients for 8 months (2 were excluded due to death, leaving 10 patients that were categorized into 2 groups). Ultrasounds were performed to evaluate vascular involvement.
Results showed that 80% of patients with conventional metal needles presented injuries, while only 40% of the fistula catheter group developed damage, which resolved during the study. No significant changes in native arteriovenous fistula flow were observed in either group.
Ultrasound monitoring allowed changes to puncture sites to
prevent long-term complications. It is concluded that the use of fistula catheters, along with ultrasound and trained personnel, can reduce complications and prolong the life of vascular access, avoiding unnecessary surgical procedures and improving the quality of hemodialysis treatment.