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vascular access device

Gennaro Giustino, Roxana Mehran, Roland Veltkamp, Michela Faggioni, Usman Baber, George D Dangas
OBJECTIVES: The aim of this study was to investigate the efficacy and safety of intraprocedural embolic protection (EP) during transcatheter aortic valve replacement (TAVR). BACKGROUND: Randomized controlled trials (RCTs) investigating the efficacy of EP devices during TAVR were relatively underpowered. METHODS: A systematic review and study-level meta-analysis was performed of randomized controlled trials that tested the efficacy and safety of EP during TAVR...
October 24, 2016: JACC. Cardiovascular Interventions
Snehal R Patel, Shivank Madan, Omar Saeed, Mohammed Algodi, Anne Luke, Marc Gibber, Daniel J Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine whether the nasal mucosa can serve as a surrogate for evaluating arteriovenous malformations (AVMs) related gastrointestinal (GI) bleeding in patients supported by continuous flow left ventricular assist devices (CF LVADs). BACKGROUND: Bleeding from the mucosal surfaces of GI tract, particularly AVMs, is the most common complication of CF LVAD support. The pathophysiology of AVM formation during CF LVAD support is of critical interest yet poorly understood; in large part because of the length and accessibility of the GI tract...
September 29, 2016: JACC. Heart Failure
Ali Pourdjabbar, Ryan R Reeves, Ehtisham Mahmud, Lawrence Ang, Mitul P Patel
Large bore vascular access is becoming increasingly common for a range of interventional cardiovascular procedures. In the vast majority, percutaneous closure is preplanned and successfully achieved. However, for patients with percutaneous closure failure, or those requiring prolonged hemodynamic support, alternatives to percutaneous closure are required. Currently there are no approved vascular closure devices for delayed removal of large bore sheaths and therefore, manual hemostasis or surgical closure remains the only options...
September 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Filippo Benedetto, Domenico Spinelli, Narayana Pipitò, Giambattista Gagliardo, Alberto Noto, Simona Villari, Antonio David, Francesco Spinelli
OBJECTIVE: The purpose of this study was to examine the outcomes of a vascular hybrid polytetrafluoroethylene (PTFE) graft, provided with a nitinol-reinforced section (NRS) on one end, in hemodialysis vascular access placement. METHODS: A retrospective study was conducted including all the consecutive patients who underwent Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) implantation for hemodialysis access placement between October 2013 and November 2015...
October 12, 2016: Journal of Vascular Surgery
Elizabeth J Brisbois, Maria Kim, Xuewei Wang, Azmath Mohammed, Terry C Major, Jianfeng Wu, Jessica Brownstein, Chuanwu Xi, Hitesh Handa, Robert H Bartlett, Mark E Meyerhoff
Blood-contacting devices, such as intravascular catheters, suffer from challenges related to thrombus formation and infection. Nitric oxide (NO) is an endogenous antiplatelet and antimicrobial agent. Exogenous release of NO from various polymer matrices has been shown to reduce thrombosis and infection of/on implantable medical devices. However, the clinical applications of such materials have been hindered due to factors such as NO donor leaching and thermal instability. In this study, a novel approach is demonstrated in which one lumen of commercial dual lumen catheters is dedicated to the NO release chemistry, allowing the other lumen to be available for clinical vascular access...
October 13, 2016: ACS Applied Materials & Interfaces
Jason Huang, Kristen K Patton, Jordan M Prutkin
BACKGROUND: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel implanted defibrillator for the prevention of sudden cardiac death that avoids intravascular access. Use of this device is limited by its inability to provide backup pacing. Combined use of the S-ICD with a permanent pacemaker may be the optimal choice in certain situations though experience with the use of both devices together remains limited. METHODS: We reviewed our single center experience with the S-ICD from March 2011 to November 2015...
October 13, 2016: Pacing and Clinical Electrophysiology: PACE
Massimo Lodi, Reza Far Ebrahimi, Piera Pezzotti, Luciano Carbonari
The use of the tunneled central venous catheter (CVC) is steadily increasing worldwide as a means of vascular access for hemodialysis. The increased use of these devices, which often outlive the patients, and the extended time they are used are associated with more frequent complications. Among these, one of the emerging complications is that of the "embedded" or stuck catheter. This term refers to when the catheter cannot be removed after detaching the retention cuff. In medical literature, experiences with the removal of stuck catheters are described with the use of several different methods...
September 27, 2016: Journal of Vascular Access
Nicolas Majunke, Norman Mangner, Axel Linke, Enno Boudriot, Sandra Erbs, Franziska Tietz, Sabrina Wolff, Stephan Schürer, Gerhard Schuler, Marcus Sandri
OBJECTIVE: Surgical femoral cutdown for decannulation after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is considered standard practice. However, access-site complications with this technique are not rare. The objective of this study is to evaluate feasibility, safety, and efficacy of a complete percutaneous decannulation procedure after VA-ECMO compared with the conventional surgical cutdown approach. METHODS: In 35 patients who were successfully weaned from VA-ECMO support, femoral artery and vein access sites were closed using a completely percutaneous approach in 15 patients, whereas 20 patients had conventional surgical cutdown for access-site closure...
October 2016: Journal of Invasive Cardiology
Claudia Fiorina, Giuseppe Bruschi, Luca Testa, Marco De Carlo, Federico De Marco, Giuseppe Coletti, Stefano Bonardelli, Marianna Adamo, Salvatore Curello, Giovanni Scioti, Paolo Panisi, Francesco Bedogni, Anna S Petronio, Federica Ettori
BACKGROUND: About one-third of candidates for transcatheter aortic valve implantation (TAVI) suffer from severe peripheral artery disease, making the routine femoral approach difficult or impossible. Aim was to compare the trans-axillary (TAx) and the trans-aortic (TAo) route for TAVI with Medtronic CoreValve Revalving System (CRS). METHODS: 242 (23%) out of 1049 consecutive TAVI with 18F CRS were treated in 4 high-volume Italian Centre through TAx (61%) and TAo (39%)...
October 4, 2016: Journal of Cardiovascular Surgery
Pranav Loyalka, Angelo Nascimbene, Michael Schechter, Marija Petrovic, Ajay Sundara Raman, Igor D Gregoric, Biswajit Kar
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic aortic valve has been successfully performed as an alternative to surgery. We describe our initial experience of valve-in-valve TAVI in five patients, using new generation Edwards Sapien 3 transcatheter heart valves implanted into degenerated 19 mm bioprosthetic valves. 20-mm Edwards S3 valves were offered for compassionate use. All patients had significant aortic valve stenosis. METHODS AND RESULTS: The main vascular access was achieved and pre-closed with two Proglide closure devices in one patient and Prostar closure devices in four patients...
October 3, 2016: Catheterization and Cardiovascular Interventions
Peter A Soden, Sara L Zettervall, Thomas Curran, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
OBJECTIVE: Prior studies on the cause and effect of surgical variation have been limited by utilization of administrative data. The Vascular Quality Initiative (VQI), a robust national clinical registry, provides anatomic and perioperative details allowing a more robust analysis of variation in surgical practice. METHODS: The VQI was used to identify all patients undergoing infrainguinal open bypass or endovascular intervention from 2009 to 2014. Asymptomatic patients were excluded...
September 27, 2016: Journal of Vascular Surgery
Andrew I Chin, Kathleen Tong, John P McVicar
Heart failure necessitating left ventricular assist device (LVAD) support can lead to kidney failure requiring dialysis. Some of these patients may require long-term hemodialysis (HD). Optimal vascular access for a patient on long-term HD therapy with an LVAD remains a complex issue. The majority of LVADs are of the continuous-flow type, and it has been theorized that native arteriovenous fistula maturation may be impaired in a setting of decreased pulsatile arterial flow. We describe a case of successful creation and use of an arteriovenous fistula in an HD-dependent patient with a continuous-flow LVAD...
September 27, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Lisa Kabelitz, Andrea Nonn, Kay W Nolte, Omid Nikoubashman, Ahmed Othman, Sarah Heringer, Martin Kramer, Martin Wiesmann, Marc A Brockmann
Minipigs are frequently used in (neuro-)interventional research. Longitudinal experiments may require repeated vessel access via the femoral artery. Anticoagulation and incompliance of the animals necessitates the use of a vascular closure device (VCD). The effects of the Angio-Seal VCD in minipigs were longitudinally assessed. Minipig (42±8.4 kg body weight) femoral arteries were sealed using the 8F (n = 6) or 6F (n = 7) Angio-Seal VCD. The pre-interventional femoral artery diameter was 5.1±0.4 mm (4.3-5...
2016: PloS One
Malcolm G Coulthard
Most babies with chronic renal failure are identified antenatally, and over half that are treated with peritoneal dialysis receive kidney transplants before school age. Most infants that develop acute renal failure have hypotension following cardiac surgery, or multiple organ failure. Sometimes the falls in glomerular filtration and urine output are physiological and reversible, and sometimes due to kidney injury, but (illogically) it is now common to define them all as having 'acute kidney injury'. Contrary to widespread opinion, careful interpretation of the plasma creatinine concentrations can provide sensitive evidence of early acute renal failure...
September 25, 2016: Early Human Development
Yasuhiro Nakano, Kenji Sadamatsu
Minimizing the catheter size can reduce vascular access complications and contrast dye usage in coronary angiography. The small diameter of the 4Fr guiding catheter has limited the use of several angioplasty devices such as intravascular ultrasound (IVUS) in the past. However, the combination of a novel IVUS catheter and a 0.010 guidewire makes it possible to perform IVUS-guided percutaneous coronary intervention (PCI) with a 4Fr guiding catheter. We herein report the case of a 51-year-old man with silent myocardial ischemia who underwent IVUS-guided transradial PCI with a 4Fr guiding catheter...
2016: Case Reports in Cardiology
Paul T Engels, Mete Erdogan, Sandy L Widder, Michael B Butler, Nelofar Kureshi, Kate Martin, Robert S Green
BACKGROUND: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients. METHODS: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Ashley Aaron, Selma El-Hag, Eileen de Grandis, Steve Santilli, Michael Rosenberg, Susan M Shafii, Jafar Golzarian, Rumi Faizer
PURPOSE: To report the results of percutaneous endovascular aortic aneurysm repair (PEVAR) using the superficial femoral artery (SFA) for large-bore vessel access. METHODS: We reviewed all PEVAR procedures at our institution over an 18-month period, identifying all patients who underwent PEVAR with the use of one or both SFAs for endograft delivery with dual ProGlide large-bore access closure. Indications for use of the SFA instead of the common femoral artery (CFA) included morbid obesity, CFA vessel wall disease, and scarring from previous CFA surgery...
September 22, 2016: Annals of Vascular Surgery
Shaoyong Wu, Jingxiu Huang, Zongming Jiang, Zhimei Huang, Handong Ouyang, Li Deng, Wenqian Lin, Jin Guo, Weian Zeng
BACKGROUND: A totally implantable venous access device (TIVAD) provides reliable, long-term vascular access and improves patients' quality of life. The wide use of TIVADs is associated with important complications. A meta-analysis was undertaken to compare the internal jugular vein (IJV) with the subclavian vein (SCV) as the percutaneous access site for TIVAD to determine whether IJV has any advantages. METHODS: All randomized controlled trials (RCTs) and cohort studies assessing the two access sites, IJV and SCV, were retrieved from PubMed, Web of Science, Embase, and OVID EMB Reviews from their inception to December 2015...
2016: BMC Cancer
Stavros Spiliopoulos, Panagiotis Kitrou, Nikolaos Christeas, Dimitris Karnabatidis
PURPOSE: Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head. METHODS: This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head...
September 9, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Lennart van Gils, Joost Daemen, Greg Walters, Todd Sorzano, Todd Grintz, Sam Nardone, Mattie Lenzen, Peter P T De Jaegere, Gary Roubin, Nicolas M Van Mieghem
Catheter-based interventions have become a less invasive alternative to conventional surgical techniques for a wide array of cardiovascular diseases but often create large arteriotomies. A completely percutaneous technique is attractive as it may reduce the overall complication rate and procedure time. Currently, large bore arteriotomy closure relies on suture-based techniques. Access-site complications are not uncommon and often seem related to closure device failure. The MANTA VCD is a novel collagen-based closure device that specifically targets arteriotomies between 10 and 22 Fr...
September 18, 2016: EuroIntervention
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