In order to optimize the care and resources that depend on the patient with advanced renal failure who requires the construction or maintenance of a vascular access, a protocolized program has been developed that includes the following care devices and processes :

Assistive devices

  1. External Consultation in Nephrology, for the monitoring of Vascular Access by ultrasound.
  2. External Consultation Joint Nephrology - Vascular Surgery, for the surgical mapping, orientation and prioritization of the indication of the surgical rescue of the pathology of the Vascular Access.
  3. Operating room Vascular surgery, for the creation of Vascular Access and surgical treatment of complications.
  4. Interventional Radiology Unit, for diagnostic imaging support in vascular access pathology and pathology, interventional treatment of complications (angioplasty, thrombectomy, stent placement, etc.), placement with tunneled catheter fluoroscopic support, treatment interventionist with complications associated with tunneling catheter and placement with complex transient catheter fluoroscopic support.
  5. Acute Dialysis Unit. For transient catheter placement.
  6. Chronic Dialysis Unit. For monitoring , of the patient who requires predialysis control.


  • Preparation for the creation of Vascular Access: Preoperative systematic mapping with ultrasound and angiography according to need (Nephro-Vascular consultation)
  • Surgery: creation of Vascular Access, prioritized in clinical urgency with the aim of reducing the catheter to the incident patient on hemodialysis.
  • Monitoring of Vascular Access:
    • External Consultation in Monographic Nephrology. Follow-up by ultrasound.
      • Maturation of the vascular access
      • Flow monitoring
      • Diagnosis of pathology
      • Follow-up of the pathological vascular access until the need for treatment
      • Protocol prioritization of treatment adjusted to clinical urgency
    • External Consultation Nephro-Vascular. Follow-up by ultrasound.
      • Guidance and prioritization of surgical treatment of complications according to the patient's characteristics (Cardiological situation, glomerular filtration, ECG guided puncture pending treatment avoiding catheter, residual vascular bed, etc.)
    • Interventional Radiology. Follow-up by ultrasound / angiography in the tax patient
    • Chronic Hemodialysis Unit:
      • On-site follow-up of the patient who requires an ultrasound puncture
      • Ultrasound diagnosis of pathology in dysfunction of Vascular Access
    • Acute Hemodialysis Unit:
      • Non-tunneled transient catheter eco-guided placement
  • Treatment of Complications of Vascular Access:
    • Interventional Radiology
    • Fistula - Graft:
      • Angioplasty
      • Thrombectomy
      • Stent placement
    • Catheter:
      • Fibrin sheath angioplasty
      • Striping
    • Surgery:
      • AV reconstruction in stenosis / thrombosis
      • Theft syndrome:
        • DRILL
        • RUDI
        • PAVE
        • Resource surgery