HD

1. DR. dr. Prasetyo Edi Sp. BTKV, Subsp.VE (K), FIATCVS, MH
Akses Hemodialisa
11 November 2023

2. CURRICULUM VITAE
• Pendidikan Dokter Umum FK UNS
• Pendidikan Spesialis BTKV FKUI
• Konsultan Vaskular Endovaskular,
Kolegium BTKV
• Fakultas Hukum STIH IBLAM
• Magister Hukum Kesehatan UPN Veteran
• Doktor Hukum Universitas Borobudur
• LEMHANAS RI Angkatan II / 2022
• Sekretaris Jendral HBTKVI
• Ketua Komnas Kesehatan
• Presiden IVAA
• Ketua MKDKI 2022 - 2027

4. 15
30
60
90
GFR
} End Stage Renal Disease
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
Chronic Kidney Disease
Renal Replacement Therapy
Needed

6. Types of
Vascular Access
Arteriovenous Fistula
Arteriovenous Graft
Central Venous Catheter

7. NKF KDOQI GUIDELINES, 2006

8. Know the Anatomy

11. AV Fistula
1. First choice for Primary vascular
access
2. Not in urgent need for HD
3. As distal as possible, preferably
in the non dominant upper
extremity. In cases of a failed
distal VA a more proximally
located AVF can be performed
4. Minimum internal radial artery
and cephalic vein diameter of
2.0 mm
5. For brachiocephalic (BCAVF) and
brachiobasilic (BBAVF) AVFs a
minimum arterial and venous
diameter of 3 mm is sufficient

12. AV Graft
1. Second choice if there are no options
for creating an autogenous AVF
2. avoidance of CVCs with their
inherent high risk of infection, in
particular when (sub)acute HD
treatment is necessary and AVF crea-
tion/maturation is problematic
3. Short-term patency is great but,
long-term patency is hampered by
thrombotic occlusions, due to
stenoses caused by progressive
neointimal proliferation
4. Elderly patients may benefit from the
use of AVGs, because of the high
primary autogenous AVF failure rate
in these patients

13. Brachio- Basilic Transposition,
Secondary Native Fistula Technique
1
3

14. Eur J Vasc Endovasc Surg (2018) 55, 757e818

15. Statistik RS Sentra Medika
Agustus 2016- Juli 2019
0
200
400
600
800
1000
1200
agustus 2016-
juli 2017
agustus 2017-
juli 2018
agustus 2018-
juli 2019
AVS
CDL

16. Perbandingan Jumlah Pasien AVS RS Sentra Medika
Januari-Juli ; 2017-2019
0
20
40
60
80
100
120
140
160
180
Januari Februari Maret April Mei Juni Juli
2017
2018
2019

17. Perbandingan Jumlah Pasien CDL RS Sentra Medika
Januari-Juli ; 2017-2019
0
20
40
60
80
100
120
Januari Februari Maret April Mei Juni Juli
2017
2018
2019

18. Thrill on day 7 post AV Fistulae Procedure,
Sentra Medika Hospital (Juli 2018-Juni 2019)
92
8
(%)
Thrill (+)
Thrill (-)
12/11/2023 18

19. Vascular access profile in haemodyalisis at
Cipto Mangunkusumo Hospital at 2012
M. Relly Sofiar

20. Non-surgical AVF Creation :
Will it Improve Care?
Dheeraj K. Rajam MD, FRCPC, FSIR, FACR
Professor and Division Head – Vascular and Interventional Radiology
University of Toronto

24. Why Do Patients Refuse AVF Surgery?
1. Chaudhry et al. JVA 2011; 12 (2): 120-126
2. BD Bard data on file. AAKP Survei Results of 150 dialysis patients

25. Who is a candidate?

35. Lobektomi
Kompetensi Bedah
Thoraks Vascular

36. Open Chest Cardiac et cause
Cardiac tamponade
dengan hematotoraks pasca ablasi
KETERLAMBATAN RUJUKAN
BERAKIBAT MORTALITAS