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AVF for hemodialysis

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https://www.readbyqxmd.com/read/28320412/high-resolution-hemodynamic-profiling-of-murine-arteriovenous-fistula-using-magnetic-resonance-imaging-and-computational-fluid-dynamics
#1
Daniel Pike, Yan-Ting Shiu, Maheshika Somarathna, Lingling Guo, Tatyana Isayeva, John Totenhagen, Timmy Lee
BACKGROUND: Arteriovenous fistula (AVF) maturation failure remains a major cause of morbidity and mortality in hemodialysis patients. The two major etiologies of AVF maturation failure are early neointimal hyperplasia development and persistent inadequate outward remodeling. Although hemodynamic changes following AVF creation may impact AVF remodeling and contribute to neointimal hyperplasia development and impaired outward remodeling, detailed AVF hemodynamics are not yet fully known...
March 20, 2017: Theoretical Biology & Medical Modelling
https://www.readbyqxmd.com/read/28297070/elbow-avf-configurations-and-indications
#2
Selcuk Baktiroglu, Fatih Yanar, Sercan Yuksel, Burak Celik, Halime G Kilic
INTRODUCTION: Brescia-Cimino radiocephalic arteriovenous fistula (AVF) remains the first-choice vascular access procedure for patients in need of long-term hemodialysis. The average life expectancy of patients receiving hemodialysis has increased in recent years and many patients now live longer and require secondary or tertiary procedures. Elbow fistulas should only rarely be constructed as primary fistulas. The aim of the surgeon must be not only to achieve a functioning fistula, but to avoid possible complications other than failure to mature (FTM), like distal ischemia and cardiac failure and to save the vessels as much as possible for future procedures...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297054/optimal-timing-for-vascular-access-creation
#3
Tamara K Jemcov, Wim Van Biesen
Many guidelines recommend that end-stage renal disease (ESRD) patients should have a permanent vascular access, preferably an autologous arteriovenous fistula (AVF), at the start of renal replacement therapy. Nevertheless, a large proportion of patients still start hemodialysis with a central venous catheter (CVC). On the other hand, there are increasing numbers of patients in whom an AVF has been created, but who never actually end up on dialysis, as well as a substantial number of patients in whom creation of a vascular access has been attempted unsuccessfully...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297050/preoperative-computer-simulation-for-planning-of-vascular-access-surgery-in-hemodialysis-patients
#4
Niek Zonnebeld, Wouter Huberts, Magda M van Loon, Tammo Delhaas, Jan H M Tordoir
INTRODUCTION: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis patients. Unfortunately, 20-40% of all constructed AVFs fail to mature (FTM), and are therefore not usable for hemodialysis. AVF maturation importantly depends on postoperative blood volume flow. Predicting patient-specific immediate postoperative flow could therefore support surgical planning. A computational model predicting blood volume flow is available, but the effect of blood flow predictions on the clinical endpoint of maturation (at least 500 mL/min blood volume flow, diameter of the venous cannulation segment ≥4 mm) remains undetermined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297048/upper-arm-hemodialysis-access-in-sweden
#5
Ulf Hedin, Gunilla Welander
AIM: To provide the contemporary use of upper-arm access for hemodialysis in Sweden using data from a unique national registry for hemodialysis access. METHODS: Data were retrieved from a nation-wide registry for dialysis access in Sweden, Dialysis Access Database (DiAD) on the use and function of specific access types with a focus on upper-arm accesses. RESULTS: The data demonstrate an increased use of upper-arm access, likely dependent on a changing patient population, with brachiocephalic arteriovenous fistula (AVF) as the most common access type...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297046/is-shear-stress-the-key-factor-for-avf-maturation
#6
Andrea Remuzzi, Michela Bozzetto, Paolo Brambilla
Autologous arteriovenous fistula (AVF) is the preferred choice for providing vascular access to hemodialysis (HD) patients, but it is still affected by high incidence of non-maturation or early failure. After creation, AVF must undergo vascular remodeling, a process characterized by an increase in blood vessel diameter and wall thickness, to allow efficient and adequate HD. A growing body of evidence indicates that AVF maturation is related to the response of endothelial cells (ECs) to changes in wall shear stress (WSS), and in particular, to changes of its peak value...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297045/surgical-technique-determines-the-outcome-of-the-brescia-cimino-avf
#7
Surendra Shenoy
Over the past 50 years, since Dr. Appel performed the first internal vascular access procedure for hemodialysis, the distal radiocephalic arteriovenous fistula continues to be the access of choice. Over time, failure to maturation has evolved as a major problem associated with this procedure depriving its benefits to many patients with end-stage renal disease. A variable incidence of this problem within similar patients suggests that surgical technique may play an important role in the development of non-maturation...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28295984/safety-of-arteriovenous-fistulae-and-grafts-for-continuous-renal-replacement-therapy-the-michigan-experience
#8
Anas Al Rifai, Nidhi Sukul, Robert Wonnacott, Michael Heung
INTRODUCTION: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end-stage renal disease (ESRD) patients. METHODS: Single-center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access-related complications...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28289682/stent-grafts-can-convert-unusable-upper-arm-arteriovenous-fistulas-into-a-functioning-hemodialysis-access-a-retrospective-case-series
#9
Charudatta S Bavare, Tiffany K Street, Eric K Peden, Mark G Davies, Joseph J Naoum
INTRODUCTION: Not all newly created arteriovenous fistulas (AVFs) successfully mature and develop into a functioning access for hemodialysis. Percutaneous transluminal angioplasty (PTA) and balloon-assisted maturation (BAM) have been utilized to either treat flow-limiting stenoses or to promote and accelerate maturation. We hypothesized that unusable upper arm AVFs can be rescued by conversion to a functional access using the percutaneous placement of a stent graft (SG). METHODS: Clinical data on 12 patients with an early non-usable upper arm AVF underwent percutaneous revision using SGs...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28288599/clinical-use-of-computational-modeling-for-surgical-planning-of-arteriovenous-fistula-for-hemodialysis
#10
Michela Bozzetto, Stefano Rota, Valentina Vigo, Francesco Casucci, Carlo Lomonte, Walter Morale, Massimo Senatore, Luigi Tazza, Massimo Lodi, Giuseppe Remuzzi, Andrea Remuzzi
BACKGROUND: Autogenous arteriovenous fistula (AVF) is the best vascular access (VA) for hemodialysis, but its creation is still a critical procedure. Physical examination, vascular mapping and doppler ultrasound (DUS) evaluation are recommended for AVF planning, but they can not provide direct indication on AVF outcome. We recently developed and validated in a clinical trial a patient-specific computational model to predict pre-operatively the blood flow volume (BFV) in AVF for different surgical configuration on the basis of demographic, clinical and DUS data...
March 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28267753/impact-of-arteriovenous-fistula-blood-flow-on-serum-il-6-cardiovascular-events-and-death-an-ambispective-cohort-analysis-of-64-chinese-hemodialysis-patients
#11
Zhizhi Hu, Fengmin Zhu, Nan Zhang, Chunxiu Zhang, Guangchang Pei, Pengge Wang, Juan Yang, Yujiao Guo, Meng Wang, Yuxi Wang, Qian Yang, Han Zhu, Wenhui Liao, Zhiguo Zhang, Ying Yao, Rui Zeng, Gang Xu
Flows (Qa) of arteriovenous fistula (AVF) impact the dialysis adequacy in hemodialysis (HD) patients. However, data for different access flow levels on outcomes related to long-term dialysis patients, especially in Chinese patients, are limited. Herein, we performed an ambispective, mono-centric cohort study investigating the association between the AVF flows and inflammation, cardiovascular events and deaths in Chinese hemodialysis patients bearing a radio-cephalic fistula (AVF) from 2009 to 2015. Twenty-three patients (35...
2017: PloS One
https://www.readbyqxmd.com/read/28246500/percutaneous-treatment-of-thrombosed-hemodialysis-arteriovenous-fistulas-use-of-thromboaspiration-and-balloon-angioplasty
#12
Burak Mehmet Çildağ, Kutsi Ömer Faruk Köseoğlu
BACKGROUND: Endovascular strategies have been used to manage patients with thrombosed vascular access for hemodialysis. We analyzed primary success rate and patency rates of balloon angioplasty following mechanical thrombectomy for the treatment of thrombosed native arteriovenous fistulas. METHODS: This was a retrospective study of 24 patients with thrombosed native arteriovenous fistulas who were referred for treatment in the intervention unit of the Radiology Department...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28236919/a-randomized-controlled-trial-and-cost-effectiveness-analysis-of-early-cannulation-arteriovenous-grafts-versus-tunneled-central-venous-catheters-in-patients-requiring-urgent-vascular-access-for-hemodialysis
#13
Emma Aitken, Peter Thomson, Leigh Bainbridge, Ram Kasthuri, Belinda Mohr, David Kingsmore
OBJECTIVE: Early cannulation arteriovenous grafts (ecAVGs) are proposed as an alternative to tunneled central venous catheters (TCVCs) in patients requiring immediate vascular access for hemodialysis (HD). We compared bacteremia rates in patients treated with ecAVG and TCVC. METHODS: The study randomized 121 adult patients requiring urgent vascular access for HD in a 1:1 fashion to receive an ecAVG with or without (+/-) an arteriovenous fistula (AVF; n = 60) or TCVC+/-AVF (n = 61)...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28218363/sex-race-and-hemodialysis-vascular-access-processes
#14
Rita L McGill, Eduardo Lacson
PURPOSE: Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging. METHODS: US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 - December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments...
February 8, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28217059/ultrasound-guided-axillary-brachial-plexus-block-versus-local-infiltration-anesthesia-for-arteriovenous-fistula-creation-at-the-forearm-for-hemodialysis-in-patients-with-chronic-renal-failure
#15
W H Nofal, S M El Fawal, A A Shoukry, Eas Sabek, Wfa Malak
BACKGROUND: The primary failure rate for arteriovenous fistula (AVF) creation under local anesthesia for hemodialysis is about 30%. Axillary brachial plexus block (BPB) may improve blood flow through blood vessels used in fistula creation; it may improve the AVF blood flow and thus may reduce the primary failure rate after 3 months. METHODS: Hundred and forty patients with chronic renal failure scheduled for AVF creation for hemodialysis were divided into two equal groups; Group 1 (AxBP-G) received ultrasound (US) guided axillary BPB, and Group 2 (LI-G) received local infiltration...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28185405/evaluation-of-long-term-combination-therapy-with-peritoneal-dialysis-and-hemodialysis
#16
Reo Kanda, Hiroaki Io, Junichiro Nakata, Yuko Makita, Yu Sasaki, Mayumi Matsumoto, Keiichi Wakabayashi, Yasuhiko Tomino, Yusuke Suzuki
It is well known that a combination therapy with peritoneal dialysis (PD) and hemodialysis (HD) is feasible and may improve clinical status in patients for whom adequate solute and fluid removal is difficult to achieve with PD alone. The objective of the present study was to evaluate whether the therapy is useful in the likelihood of long-term peritoneal membrane and cardiac function. The therapy was 6 days of PD and one session of HD per week. Physical, biochemical, dialysate-to-plasma ratio of creatinine (D/P Cr), arteriovenous fistula (AVF) blood flow, and left ventricular mass index (LVMI) data were prospectively analyzed in 30 patients with measurements performed at 0 and 6 months, and for 21 patients, 12 or 18 months after initiation of the therapy...
February 10, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28163173/increased-oxidative-stress-and-hypoxia-inducible-factor-1-expression-during-arteriovenous-fistula-maturation
#17
Nirvana Sadaghianloo, Kota Yamamoto, Hualong Bai, Masayuki Tsuneki, Clinton D Protack, Michael R Hall, Serge Declemy, Réda Hassen-Khodja, Joseph Madri, Alan Dardik
BACKGROUND: The poor clinical results that are frequently reported for arteriovenous fistulae (AVF) for hemodialysis are typically due to failure of AVF maturation. We hypothesized that early AVF maturation is associated with generation of reactive oxygen species and activation of the hypoxia-inducible factor-1 (HIF-1) pathway, potentially promoting neointimal hyperplasia. We tested this hypothesis using a previously reported mouse AVF model that recapitulates human AVF maturation. METHODS: Aortocaval fistulae were created in C57Bl/6 mice and compared with sham-operated mice...
February 3, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28133903/hypoproteinemia-as-a-prognostic-risk-factor-for-arteriovenous-fistula-failure
#18
Vedran Premuzic, Tvrtko Hudolin, Josip Pasini, Zoran Zimak, Dinko Hauptman, Bojan Jelakovic, Zeljko Kastelan
INTRODUCTION: Any vascular access is of limited duration with many factors which influence survival in patients on chronic hemodialysis (HD). Hypoproteinemia as a marker of chronic illness is common among chronic HD patients. Our aim was to analyze the survival of the primary arteriovenous fistula (AVFs) and the risk factors which influence their patency and to test the hypothesis that patients with normal values of serum proteins have lower risk of AVF failure compared to patients with hypoproteinemia...
January 29, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28124305/calcification-in-arteriovenous-fistula-blood-vessels-may-predict-arteriovenous-fistula-failure-a-5-year-follow-up-study
#19
Aleksandar Jankovic, Tatjana Damjanovic, Zivka Djuric, Jelena Marinkovic, Georg Schlieper, Petar Djuric, Jelena Tosic Dragovic, Ana Bulatovic, Milos Mitrovic, Jovan Popovic, Jürgen Floege, Nada Dimkovic
PURPOSE: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. The impact of vascular calcification process on AVF survival remains unclear and results of several studies about this issue are controversial. In the light of the new knowledge about the different susceptibility for calcification process in different blood vessels, the aim of our study was to analyze whether the calcification of AVF-blood vessels may have an impact on AVF longevity. METHODS: The study included 90 patients, 49 males and 41 females, all of them Caucasians, with a mean age 62 ± 11 years, on regular hemodialysis for more than 1 year with patent primary AVFs...
January 25, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#20
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
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