الفهرس 
AtherosclerosisOnly 14 pages are availabe for public view
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Abstract
Manifestation of atherosclerosis is one of the alterations in venous bypass grafts. The venous part of a hemodialysis fistula can be compared to a venous bypass graft, so looking at the venous part of hemodialysis fistulae may be an adequate model to investigate the initiation and progression of atherosclerotic lesions in venous by pass grafts.
Thrombotic occlusion is an important complication of arteriovenous fistulae constructed for hemodialysis access an the major reason for faliure of the access site. Progressive stenosis in the anastomotic vessels or efferent vein has been recognized as the major cause for fistulae thrombosis. Although the stenosis may be related to the technical performance of the anastomosis, in the main it can be attributed to chronic changes known to occur in the run off veins of arteriovenous fistulae. These changes are related to venous pressure, to local hemodynamic effects and probably to hypoxia. The development of intimal fibromuscular hyperplasia may result from focal endothelial trauma caused by the shearing effect of blood flow at the site of the venous anastomosis. Segmental stenosis of autogenous fistulae has also been noted to occur from fibrosis and intimal hyperplasia secondary to the trauma of repeated needle punctures.