A. Djenane, A. Laribi, P. Bourquelot, F. Haddoum.
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1 A. Djenane, A. Laribi, P. Bourquelot, F. Haddoum. Services Néphrologie CHU LAGHOUAT et MUSTAPHA ALGER 29 Juin 2018
2 1947:Les Pionniers de l Hémodialyse Cellulose Heparine Accès Vasculaire This image from the archives of LIFE magazine, which first appeared on April 28, 1947, CAMERON JS. Practical haemodialysis began with cellophane and heparin: the crucial role of William Thalhimer ( ). Nefrol Dial Transplant 2000, 15:
3 Boston, Le 23/12/1954 États Unis SEATTLE 1960 Mr Clyde Shield, premier patient dialysé chronique au monde par l'équipe de Belding H.Scribner Première transplantation de rein couronnée de succès entre les jumeaux monozygotes Richard et Ronald Herrick
4 Scribner Shunt-1960 Original Cimino-Brescia Fistula side-by-side
5 CIMINO and BRESCIA 1966 New York USA
6 Abords Vasculaires pour HD 1960 : Shunt de Scribner 1966: FAV (Brescia et Cimino) Catheter central jugulaire interne Pontage artério-veineux
7 Short History of Hemodialysis Access after Scribner Shunt:
8 AAV et MRC le BON «TIMMING Stade 5 Stade 4 Stade 3 >3 mois et < 1 an PROTECTION DU CAPITAL VEINEUX Stade 2 Stade 1
9 La prescription de la préservation du capital vasculaire sur les ordonnances pour les bilans biologiques m o
10 Examen clinique avant FAV Premier rendez-vous en situation «froide «La veille de l opération en situation «chaude»
11
12 Recommandations Américaines: K-DOQI 2007 mise à jour fin 2017 Royaume-Uni: 2015 Canadiennes: 2006 Européennes: EBPG 2007 FAV > Pontage (AVG) > CVCT (CVCTunnélisé)
13 NDT 2014
14 Survie de l Accès Vasculaire Survie technique FAV, Euro FAV, US PTFE, US 40 DOPPS 20 Cath permanents, US Jours
15 Sténose Veine Centrale sur Cathéter JI
16 Sténose Veine Centrale + FAV
17 ET DANS LA VRAIE VIE? 17
18 EPH Arris, Algérie Primo-Abord pour la 1 ère Séance 12 pt KT jugulaire FAV
19 IRCT : Incidence en EPH Laghouat, Algérie 37 pt FAV 19% KT 81%
20 France 2011: Registre REIN Primo-Abord en Urgence La première voie d abord a été un CVC chez 56 % des patients (40 à 94%), 33 % (20 à 60%) ont commencé la dialyse en urgence, Hors urgence, la FAV a été faite avant la 1ére dialyse dans 85% des cas (>3 mois). REIN 2011
21 542 First AV Accesses 17% 2% Radial Cephalic Ulnar Basilic 11% 3% 69% Brachial Cephalic Brachial Basilic PTFE
22 France 2011 (pts prévalents au 31/12/2011) % FAV Prothèse CVC REIN <65 ans ans ans au 31/12/ ans 22
23 REIN 2015: AV: disparités interrégionales FAV 80% CVC< 20% FAV 70% CVC/protheses 30%
24 International Differences in the Location and Use of Arteriovenous Accesses Created for Hemodialysis: Results From the Dialysis Outcomes and Practice Patterns Study (DOPPS) Ronald L. Pisoni, Lindsay Zepel, Richard Fluck, Charmaine E. Lok, Hideki Kawanishi, Gültekin Süleymanlar, Haimanot Wasse, Francesca Tentori, Jarcy Zee, Yun Li, Douglas Schaubel, Steven Burke, Bruce Robinson American Journal of Kidney Diseases Volume 71, Issue 4, Pages (April 2018) DOI: /j.ajkd Copyright 2017 The Authors Terms and Conditions
25 American Journal of Kidney Diseases , DOI: ( /j.ajkd ) Copyright 2017 The Authors Terms and Conditions Figure 1
26 American Journal of Kidney Diseases , DOI: ( /j.ajkd ) Copyright 2017 The Authors Terms and Conditions Figure 3
27 Percutaneous Endoluminal AVF Creation 27
28 Percutaneous Endoluminal AVF Creation
29 Pilot Study Rajan DJ et al. JVIR 2015 From 8/2012 to 9/2013, 33 attempt-avf creation between normal proximal ulnar artery and closely associated normal ulnar vein (diameters 3mm) in selected pts. Results: a pavf was successfully created in 32 of 33 patients (97%) 4 unrelated deaths, 1 lost to follow-up. 27 remaining patients: Mean time to maturation was 58 days (range: ). 24 were undergoing successful dialysis via their pavf at 6 months. 2 patients had usable access but did not initiate dialysis during the study. 1 pavf thrombosis occurred in a patient with preexisting CVS. Cumulative pavf patency at 3 months was 96% (SE=4%). One serious procedure-related adverse event and 5 minor adverse events
30 ABV UN VRAI CHALLENGE
31 Wardrobe Requirements Natalie Cole, 2009
32 Did you notice this first? Natalie Cole, 2009
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