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Arteriovenous access

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https://www.readbyqxmd.com/read/29905522/intraoperative-angiography-via-the-popliteal-artery-a-useful-technique-for-patients-in-the-prone-position
#1
Nicolas W Villelli, David M Lewis, Thomas J Leipzig, Andrew J DeNardo, Troy D Payner, Charles G Kulwin
OBJECTIVE Intraoperative angiography can be a valuable tool in the surgical management of vascular disorders in the CNS. This is typically accomplished via femoral artery puncture; however, this can be technically difficult in patients in the prone position. The authors describe the feasibility of intraoperative angiography via the popliteal artery in the prone patient. METHODS Three patients underwent intraoperative spinal angiography in the prone position via vascular access through the popliteal artery. Standard angiography techniques were used, along with ultrasound and a micropuncture needle for initial vascular access...
June 15, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29903522/vascular-access-clinic-results-before-and-after-implementing-a-multidisciplinary-approach-adding-routine-doppler-ultrasound
#2
Inés Aragoncillo Sauco, José Manuel Ligero Ramos, Almudena Vega Martínez, Ángel Luis Morales Muñoz, Soraya Abad Estébanez, Nicolás Macías Carmona, Diego Ruiz Chiriboga, Rosario García Pajares, Teresa Cervera Bravo, Juan Manuel López-Gómez, Soledad Manzano Grossi, Elena Menéndez Sánchez, Javier Río Gomez, Ana María García Prieto, Tania Linares Grávalos, Fernando Garcia Boyano, Luis Manuel Reparaz Asensio, Marta Albalate Ramón, Patricia de Sequera Ortiz, Beatriz Gil Casares, Jara Ampuero Mencía, Sandra Castellano, Belén Martín Pérez, José Luís Martín Conty, Alba Santos Garcia, José Luño Fernandez
BACKGROUND: A multidisciplinary approach and Doppler ultrasound (DU) assessment for the creation and maintenance of arteriovenous fistulas (AVF) for haemodialysis can improve prevalence and patency. The aim of this study was to analyse the impact of a new multidisciplinary vascular access (VA) clinic with routine DU. MATERIAL AND METHODS: We analysed the VA clinic results from 2014 and 2015, before and after the implementation of a multidisciplinary team protocol (vascular surgeon/nephrologist) with routine DU in preoperative mapping and prevalent AVF...
June 11, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29893920/superior-vena-cava-stenosis-in-haemodialysis-patients-with-a-tunnelled-cuffed-catheter-prevalence-and-risk-factors
#3
Laura Labriola, Benjamin Seront, Ralph Crott, Pauline Borceux, Frank Hammer, Michel Jadoul
Background: Although superior vena cava (SVC) stenosis may be a life-threatening complication of haemodialysis (HD) catheters, its prevalence and risk factors in HD patients are unknown. Our aim was to assess the prevalence and risk factors for SVC stenosis in HD patients with a tunnelled cuffed catheter (TCC) and to describe its clinical presentation. Methods: In this single-centre, retrospective cohort study, all in-centre chronic HD patients carrying a TCC (1 January 2008-31 December 2012) were included (n = 117 patients, 214 TCC, 80 911 catheter-days)...
June 8, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29886220/removal-of-non-infected-arteriovenous-fistulae-following-kidney-transplantation-is-a-safe-and-beneficial-management-strategy-for-unused-dialysis-access
#4
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29879718/acute-kidney-injury-before-dialysis-initiation-predicts-adverse-outcomes-in-hemodialysis-patients
#5
Timmy Lee, Silvi Shah, Anthony C Leonard, Pratik Parikh, Charuhas V Thakar
BACKGROUND: Acute kidney injury (AKI) is associated with increased morbidity and mortality. Mortality in end-stage renal disease (ESRD) patients is highest during the first year of dialysis. The impact of pre-ESRD AKI events on long-term outcomes in incident ESRD patients remains unknown. METHODS: We evaluated a retrospective cohort of 47,341 incident hemodialysis patients from the United States Renal Data System with linked Medicare data for at least 2 years prior to hemodialysis initiation...
June 7, 2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29875179/planning-vascular-access-in-peritoneal-dialysis-defining-high-risk-patients
#6
Hugo Ferreira, Ana T Nunes, Ana Oliveira, Ana Beco, Joana Santos, Manuel Pestana
BACKGROUND: Peritoneal dialysis (PD) is an effective renal replacement technique. However, every year a considerable number of patients are transferred to hemodialysis (HD). Our aim was to identify those at risk, in order to place an arteriovenous fistula (AVF). METHODS: Case-control study enrolling all prevalent patients in 2014 and 2015 in our clinic. Groups: 72 case patients who were transferred definitively to HD, 111 control patients (remaining on PD, transplanted, recovered renal function, or deceased)...
June 6, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29874975/subjective-global-assessment-dialysis-malnutrition-score-and-arteriovenous-fistula-outcome-a-comparison-with-charlson-comorbidity-index
#7
Leonardo Spatola, Silvia Finazzi, Albania Calvetta, Claudio Angelini, Salvatore Badalamenti
INTRODUCTION: Malnutrition is a well-recognized risk factor for all-cause mortality in hemodialysis patients. However, its role for arteriovenous fistulas outcome has not been exhaustively investigated. Our aim was to point out the impact of Subjective Global Assessment-Dialysis Malnutrition Score as independent predictor of arteriovenous fistulas thrombosis (vascular access thrombosis) and/or significant stenosis (vascular access stenosis). In addition, we compared it with the widespread Charlson Comorbidity Index...
June 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29860739/-endovascular-intervention-in-central-venous-stenosis-and-obstructions-in-the-middle-aged-and-elderly-hemodialysis-patients-a-single-center-experience
#8
Yu Yu Garin, K L Kozlov, D S Medvedev
Central vein stenosis and obstruction is one of the main risk factors in vascular access failure among hemodialysis patients. The elderly patients are in a particularly group because of some problems of arteriovenous fistula creation and maintenance. To evaluate the effectiveness and safety of percutaneous transluminal angioplasty for the treatment of central vein stenosis and obstruction in the middle aged and elderly hemodialysis patients. Forty eight hemodialysis patients with central vein stenosis and obstruction were treated from 2010 to 2016...
2018: Advances in Gerontology, Uspekhi Gerontologii
https://www.readbyqxmd.com/read/29843559/no-consensus-on-physicians-preferences-on-vascular-access-management-after-kidney-transplantation-results-of-a-multi-national-survey
#9
Bram M Voorzaat, Cynthia J Janmaat, Esther D Wilschut, Koen Ea Van Der Bogt, Friedo W Dekker, Joris I Rotmans
OBJECTIVE: Arteriovenous fistulas for hemodialysis vascular access are a burden for the cardiovascular system. After successful kidney transplantation, prophylactic arteriovenous fistula ligation may improve cardiac outcomes; however, evidence is scarce. This survey investigates physicians' preference for management of arteriovenous fistulas and identifies the factors associated with preference for either arteriovenous fistula ligation or maintenance. MATERIALS AND METHODS: A survey was sent to members of eight national and international Nephrology and Vascular Surgery societies...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29843483/minimally-invasive-limited-ligation-endoluminal-assisted-revision-miller-a-review-of-the-available-literature-and-brief-overview-of-alternate-therapies-in-dialysis-associated-steal-syndrome
#10
REVIEW
William W Sheaffer, Patrick T Hangge, Anthony H Chau, Sadeer J Alzubaidi, M-Grace Knuttinen, Sailendra G Naidu, Suvranu Ganguli, Rahmi Oklu, Victor J Davila
Dialysis associated steal syndrome (DASS) is a relatively rare but debilitating complication of arteriovenous fistulas. While mild symptoms can be observed, if severe symptoms are left untreated, DASS can result in ulcerations and limb threatening ischemia. High-flow with resultant heart failure is another documented complication following dialysis access procedures. Historically, open surgical procedures have been the mainstay of therapy for both DASS as well as high-flow. These procedures included ligation, open surgical banding, distal revascularization-interval ligation, revascularization using distal inflow, and proximal invasion of arterial inflow...
May 29, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29809130/-femoral-vein-transposition-arteriovenous-fistula-for-haemodialysis
#11
Lene Langhoff Clausen, Judith Nielsen
An upper extremity vascular access (VA) is preferred for haemodialysis, but when the central veins are occluded or all opportunities are exhausted, a lower extremity VA is necessary. Transposition of the superficial femoral vein is a durable arteriovenous fistula and should be the first choice in patients with long expected remaining lifetime. Peripheral arterial disease and heart failure are contraindications, and careful selection of the patients is mandatory. There is a risk of ischaemic steal and an even higher risk of wound complications...
June 4, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29805922/sylvian-arteriovenous-malformation-resection-and-associated-middle-cerebral-artery-aneurysm-clipping-technical-nuances-of-concurrent-surgical-treatment
#12
Dale Ding, Thomas J Buell, Daniel M Raper, Ching-Jen Chen, Panagiotis Mastorakos, Kenneth C Liu, Dennis G Vollmer
Approximately 10-30% of brain arteriovenous malformations (AVM) have associated arterial aneurysms (AAA), and the management of these lesions can be challenging. In this video technical note, we demonstrate the microsurgical treatment of an unruptured, Spetzler-Martin grade I AVM in the distal Sylvian fissure with two AAAs arising proximally from the inferior M2 trunk immediately distal to the middle cerebral artery (MCA) bifurcation. First, we resected the superficially located AVM to normalize the blood flow through the Sylvian vein...
February 7, 2018: Curēus
https://www.readbyqxmd.com/read/29804798/femoral-pseudoaneurysm-closure-by-direct-access-to-stick-or-not-to-stick
#13
Manisha Ganapathi Raikar, Deepakraj Gajanana, Mohammed Haris U Usman, Nyali E Taylor, Sean F Janzer, Jon C George
Femoral artery pseudoaneurysms are usually the result of femoral artery cannulation for percutaneous cardiac or endovascular procedures. It causes compression of surrounding structures, may cause distal embolization, arteriovenous fistula formation, or might rupture. Most close spontaneously by thrombosis, and the remainder need intervention, either percutaneous or surgical repair. We describe a unique case of femoral pseudoaneurysm that was repaired percutaneously by excluding it via stenting and simultaneous closure of residual aneurysm by direct access and coil embolization...
April 12, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29784614/tradeoffs-in-vascular-access-selection-in-elderly-patients-initiating-hemodialysis-with-a-catheter
#14
Timmy Lee, Joyce Qian, Mae Thamer, Michael Allon
RATIONALE & OBJECTIVE: National vascular access guidelines recommend placement of arteriovenous fistulas (AVFs) over grafts (AVGs) in hemodialysis patients, but have not been comprehensively assessed in the elderly. We evaluated clinically relevant vascular access outcomes in elderly patients receiving an AVF or AVG after hemodialysis therapy initiation. STUDY DESIGN: Retrospective cohort study using national administrative data. SETTINGS & PARTCIPANTS: Claims data from the US Renal Data System of 9,458 US patients 67 years and older who initiated hemodialysis therapy from July 1, 2010, to June 30, 2011, with a catheter and received an AVF (n=7,433) or AVG (n=2,025) within the ensuing 6 months...
May 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29784566/preoperative-point-of-care-ultrasound-and-its-impact-on-arteriovenous-fistula-maturation-outcomes
#15
Sajjid Hossain, Amit Sharma, Luc Dubois, Guy DeRose, Audra Duncan, Adam H Power
OBJECTIVE: Duplex ultrasound as a preoperative assessment tool in the clinic may help identify anatomic factors predictive of fistula maturation. Preoperative point-of-care ultrasound (POCUS) offers surgeons an alternative to routine formal vein mapping as it can be performed by the operator during the initial clinic visit. We sought to determine the impact of POCUS as an adjunct to physical examination on arteriovenous fistula maturation. METHODS: All consecutive patients undergoing first-time dialysis access creation from December 2007 to December 2014 were retrospectively reviewed...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29781153/value-of-duplex-doppler-ultrasonography-for-the-evaluation-of-dysfunctional-hemodialysis-access-arteriovenous-fistulas-prior-to-endovascular-interventions
#16
Isik Conkbayir, Pinar Celtikci, Onur Ergun, Hasan Ali Durmaz
PURPOSE: To demonstrate accuracy of duplex Doppler ultrasonography (DUS) for the evaluation of native-vein arteriovenous fistula (AVF) dysfunction in end-stage renal disease patients. METHODS: This retrospective study included 60 patients with dysfunctioning native-vein AVF evaluated with DUS and digital subtraction angiography (DSA) whose results were compared for detection, identification, and localization of AVF lesions. We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DUS and evaluated the agreement between DUS and DSA by the Cohen's kappa coefficient (κ)...
May 21, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29750827/self-cannulation-of-the-vascular-access-in-home-hemodialysis-overcoming-patient-level-barriers
#17
Frank L Ward, Rose Faratro, Rory F McQuillan
Patients with end-stage kidney disease who are considering home hemodialysis (HHD) face the challenge of learning to self-cannulate their arteriovenous access. Current practice discourages the use of tunneled central venous catheters, with recent indications that self-cannulating patients have superior outcomes. Patient-level barriers do not appear to preclude a successful HHD program and should not be viewed as insurmountable by healthcare staff or patients. The healthcare team must address patient fears while instructing the patient to perform self-cannulation safely...
May 11, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29742952/a-pilot-study-to-measure-vascular-compliance-changes-during-fistula-maturation-using-open-source-software
#18
Barry Belmont, Dae Woo Park, Albert Shih, Matthew Leavitt, Brett Plattner, Peter K Henke, William F Weitzel
PURPOSE: Autogenous arteriovenous fistulas are the preferred access for hemodialysis. Yet when created, fistulas often fail to mature, requiring surgical or radiologic interventions before their use. This pilot study measures the vascular wall elasticity and flow gradient using an open-source ultrasound software program designed to aid in assessing fistula maturation. METHODS: A total of seven end-stage renal disease patients were enrolled for our study after providing informed consent...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29736106/a-novel-mitochondrial-dna-deletion-in-patient-with-pearson-syndrome
#19
Rame Khasawneh, Hala Alsokhni, Bayan Alzghoul, Asim Momani, Nazih Abualsheikh, Nazmi Kamal, Mousa Qatawneh
Introduction: Arteriovenous Pearson syndrome is a very rare multisystemic mitochondrial disease characterized by sideroblastic anemia and exocrine pancreatic insufficiency. It is usually fatal in infancy. Case report: We reported a four-month-old infant presented with fever and pancytopenia. Bone marrow examination showed hypoplastic changes and sideroblastic features. Molecular Study showed a novel hetroplasmic mitochondrial deletions (m. 10760 -m. 15889+) in multiple genes (ND4,ND5,ND6, CYTB)...
April 2018: Medical Archives
https://www.readbyqxmd.com/read/29730781/role-of-antiplatelet-therapy-in-the-durability-of-hemodialysis-access
#20
Satinderjit Locham, Robert J Beaulieu, Hanaa Dakour-Aridi, Besma Nejim, Mahmoud B Malas
BACKGROUND: Antiplatelet therapy (APT) is often used on anecdotal grounds to improve vascular access patency. The aim of this study was to assess the role of APT in hemodialysis (HD) patients undergoing arteriovenous fistula (AVF) or graft (AVG) placement. METHODS: All patients in a large HD vascular qualitative initiative database (2011-2017) were included and divided into no antiplatelet therapy (no-APT) vs. any APT [aspirin (ASA) or P2Y12 inhibitors (PI)]. Multivariate [logistic (MLR) and Cox (MCR) regression] analyses were used as appropriate...
May 5, 2018: Journal of Nephrology
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