[Simple technique of percutaneous ligation of accessory veins for salvage of failing arteriovenous fistulae]. / Jednoduchá technika perkutánního podvazu akcesorních zil hemodialyzacních zkratu.

INTRODUCTION: Non-maturing arteriovenous fistula is a common problem in hemodialysis units. The main reasons for maturation failure include a poor venous system, vein stenosis, stenosis in an anastomosis, or the presence of collateral veins. Currently, the usual approach to eliminate collateral vein drainage consists in surgical ligation or coil embolization; however, these procedures are time-consuming, logistically demanding and expensive. Alternatively, various types of percutaneous ligation are done. Below follows the description of a technique of image-guided percutaneous ligation of collateral veins and an analysis of our cohort of patients. METHOD: A retrospective study of prospectively enrolled patients with non-maturing arteriovenous fistulae. The criterion of success was defined as successful hemodialysis within 4 weeks after percutaneous ligation. RESULTS: During a 2-year period (March 2015 - January 2017) 7 patients underwent 11 ligations of collateral veins. In all patients the arteriovenous shunts matured successfully for hemodialysis within 2 or 3 weeks following the ligation. CONCLUSION: The novel technique is fast, inexpensive and provides a good clinical and cosmetic outcome.Key words: arteriovenous fistula - collateral veins - percutaneus ligation.

[Bloodstream infections of the intravascular access devices - case reports and review of the literature]. / Septické komplikace intravenózních portových systému - kazuistiky a prehled literatury.

Long-term access devices (VAD) in oncology patients are the elemental procedure of contemporary treatment. Apart from their indisputable benefit they are linked with an increased risk of infectious complications, ranging between simple colonisation of a device to catheter related bloodstream infections. The decision to salvage or extract the VAD in case of bloodstream infection depends on patient's clinical state, localisation of infection (site of insertion, catheter or pocket), casual agent and complications (e.g. endocarditis, septic embolization, osteomyelitis and so on). Authors present 5 case reports of portacath sepsis in their oncology department in 2011 (i.e. 4.46% of 112 inserted ports). In the second part of the article they review current literature data about prevention and treatment of infectious complications of vascular devices in cancer patients.