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Effective vascular access (VA) is an essential condition for providing hemodialysis, affecting patients’ health outcomes. We aim to explore how health literacy (HL) as a non-clinical factor is associated with the decision-making process regarding VA type selection. Using data from 20 dialysis centers across Slovakia (n = 542, mean age = 63.6, males = 60.7%), the association of HL with type of VA (arteriovenous fistula (AVF) vs. central venous catheter (CVC)) was analyzed using a logistic regression model adjusted for sociodemographic characteristics and comorbidity. Sociodemographic data and data on nine domains of HL were collected by questionnaire. Data on VA and comorbidity were obtained from a medical records. Patients with a greater ability to engage with healthcare providers (odds ratio (OR): 1.34; 95% confidence interval (CI): 1.00–1.78), those with a better ability to navigate the healthcare system (OR: 1.41; 95% CI: 1.08–1.85), those more able to find good health information (OR: 1.52; 95% CI: 1.15–2.03), and those who understand it well enough to know what to do (OR: 1.52; 95% CI: 1.12–2.06) are more likely to have AVF. Patients’ HL is associated with the type of VA; therefore, it should be considered in the decision-making process regarding the selection of the type of VA, thereby informing strategies for improving patients’ HL and doctor–patient communication.

Klippel-Trenaunay syndrome is the most frequent systemic venous angiodysplasia. It is characterized by cutaneous capillary malformations -naevus fl ammeus, excessive growth of soft and bone tissue, venous and lymphatic malformations. Investigative methods include: clinical examinations, venography as the evidence of dysplastic changes of superfi cial and / or deep venous system, the Moyne obstruction and venous insuffi ciency perforator. Treatment is conservative, related to that of chronic venous disease. The surgery is aimed at removing the varices and insuffi cient perforators (Fig. 9, Ref. 8 Clinical study 139-years old woman patient was admitted to the Clinic of vascular surgery, East Slovak Institute of Cardiovascular Diseases, Inc. in Kosice for persistent swelling of the left tibia, progression of relapsing varicose veins of the left tibia with the tendency to deterioration. In anamnesis she overcame usual childhood diseases, surgery of varicose veins in the left lower limb at the local surgical department, in the dispensary of angiologist and orthopaedist for spine scoliosis. For a long time she used venotonics and anticoagulant therapy with low molecular heparin (LMWH).Within the family there were no problems with varicose veins. At admission, on the shin on the right there were extensive stem varicosities, pre-tibial and perimalleolar oedema.Pulsations were bilaterally well tangible at full range, trophic changes of the skin and adnexes were not present. In the sacral region there was haemangioma of the size of 10x10 cm (Fig. 1).The whole left lower limb was thicker by 3-4 cm. The left foot was signifi cantly smaller than the right one, with skeletal malformation (Figs 2 and 3).In the control ultrasound of the lower limb vein system the fi nding on the left lower limb was following: v. saphena magna as well as v. saphena parva were extirpated, without any signs of recurrence, perforators on the tibia were suffi cient. On the dorsal side of the thigh the cranial extension protruding from the stump of the extirpated v. saphena parva was confi rmed by examination. It was signifi cantly dilated with the luminal diameter of 13.5 mm.Extension was drained by dilated perforator in the middle of dorsomedial side of the thigh running into v. femoralis l.sin.In the preoperative examination the normochromatic anaemic syndrome of slight degree v.s. sideropenic, leucopaenia of slight degree, and slight hypercholesterolemia dominated in the laboratory picture. According to the examination conclusion, the patient was cardio-pulmonary compensated without any contraindications to surgery.Under the total anaesthesia in the position on the abdomen, the stump of v. saphena parva l.sin was anastomized at its distal and proximal extension. The distal extension was fi brotically changed, probably after previous surgery. The proximal one was about 0.7 cm, fi brotically changed after previous infl ammations. After its skeletinization in the middle third of the back half of the thigh we ligated its tertiary part in the...

The aim of this study was to analyze the benefit of the patients after renal transplantation with an assessment of the significance of different surgical techniques in patients with renal transplantation (not only from the dead but also the living donors) with multiple arteries. 457 patients with end stage renal disease (ESRD) in the treatment using the extracorporeal elimination method (haemodialysis, or peritoneal dialysis), who in the period from 2005 to 2015 had a kidney transplant were included in our retrospective study. Our results confirm that the patients after kidney transplantation with cold ischemia time more than 12 hours have 2.5 times higher risk of delayed onset, possibly failure of graft function compared to those with cold ischemia time less than 12 hours. This confirms our experience that the best option for the patient to achieve a stable graft function with long-term perspective is cold ischemia time of less than 12 hours and the realisation of renal artery angioplasty. In this case, the risk of delayed onset of transplanted kidney function or graft failure decreases 4.5 times compared to the respondents with cold ischemia time more than 12 hours without carrying out arterial angioplasty (Tab. 1, Fig. 4, Ref. 16).

Klippel-Trenaunay syndrome is the most frequent systemic venous angiodysplasia. It is characterized by cutaneous capillary malformations -naevus flammeus, excessive growth of soft and bone tissue, venous and lymphatic malformations.Investigative Methods Include: clinical examinations, venography as the evidence of dysplastic changes of superficial and / or deep venous system, the Moyne obstruction and venous insufficiency perforator. Treatment is conservative, related to that of chronic venous disease. The surgery is aimed at removing the varices and insufficient perforators.