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AVF for hemodialysis

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https://www.readbyqxmd.com/read/29793010/restoration-of-autologous-arteriovenous-fistula-by-removal-of-the-occluded-short-venous-part-and-venovenous-end-to-end-anastomosis-in-a-hemodialysis-patient
#1
Tsuyoshi Takashima, Keiichiro Matsumoto, Chihiro Takeshita, Eriko Nonaka, Sae Matsushita, Makoto Fukuda, Motoaki Miyazono, Yuji Ikeda
Standard salvage procedures for occuluded autologous arteriovenous fistula (AVF) in a hemodialysis patient are endovascular and/or surgical therapy. When endovascular therapy and thrombectomy prove unsuccessful, it is most likely that creating a new AVF or arteriovenous graft will be considered. However, if the occuluded venous part is short, we have adopted an operative technique for repair of AVF by removal of the occluded short venous part and venovenous end-to-end anastomosis. To our knowledge, the efficacy and clinical course of restoration of AVF by the technique have not been reported to date...
May 21, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29784614/tradeoffs-in-vascular-access-selection-in-elderly-patients-initiating-hemodialysis-with-a-catheter
#2
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/29781153/value-of-duplex-doppler-ultrasonography-for-the-evaluation-of-dysfunctional-hemodialysis-access-arteriovenous-fistulas-prior-to-endovascular-interventions
#3
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/29779960/comparison-of-hemodialysis-arteriovenous-fistula-blood-flow-rates-measured-by-doppler-ultrasound-and-phase-contrast-magnetic-resonance-imaging
#4
Yong He, Yan-Ting Shiu, Daniel B Pike, Prabir Roy-Chaudhury, Alfred K Cheung, Scott A Berceli
OBJECTIVE: The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. METHODS: Blood flow rates in the proximal artery (PA) and draining vein (DV) of newly created upper extremity AVFs were measured and compared using DUS and phase-contrast MRI at 1 day, 6 weeks, and 6 months postoperatively...
May 17, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29730781/role-of-antiplatelet-therapy-in-the-durability-of-hemodialysis-access
#5
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
https://www.readbyqxmd.com/read/29724122/a-meta-analysis-of-the-association-between-diabetic-patients-and-avf-failure-in-dialysis
#6
Yan Yan, Dan Ye, Liu Yang, Wen Ye, Dandan Zhan, Li Zhang, Jun Xiao, Yan Zeng, Qinkai Chen
PURPOSE: The most preferable vascular access for patients with end-stage renal failure needing hemodialysis is native arteriovenous fistula (AVF) on account of its access longevity, patient morbidity, hospitalization costs, lower risks of infection and fewer incidence of thrombotic complications. Meanwhile, according to National Kidney Foundation (NKF)̸Dialysis Out-comes Quality Initiative (DOQI) guidelines, AVF is more used than before. However, a significant percentage of AVF fails to support dialysis therapy due to lack of adequate maturity...
November 2018: Renal Failure
https://www.readbyqxmd.com/read/29701407/creative-vascular-access-construction-in-same-patient
#7
Pedro Pinto Sousa, Paulo Almeida, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Creating and maintaining a functional vascular access(VA) is a critical factor in the survival of a dialysis patient. However, it will not function forever, implying a creative attitude from the vascular surgeon either to maintain its functionality or built a new one wherever possible, being it autologous or synthetic. METHODS: Describe the VA history of a 59years-old male with morbid obesity and end-stage chronic kidney disease. RESULTS: His VA construction started in2012 with failed attempts in both forearms until a functional brachiocephalic artery-venous fistula(AVF) in the right upper limb was achieved, but was deemed to ligation as severe venous hypertension secondary to central venous disease related to CVC use...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29680929/evaluation-of-factors-affecting-time-to-achieve-dry-weight-among-hemodialysis-patients-using-bioimpedance-spectroscopy
#8
Amjad Khan, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Nafees Ahmad, Siew Hua Gan
BACKGROUND: Achieving and maintaining dry weight appears to be an effective strategy for controlling and maintaining normotension among hypertensive patients on hemodialysis (HD). OBJECTIVE: The present study aimed to determine the time at which the majority of patients achieve postdialysis dry weight using bioimpedance spectroscopy (BIS). METHODS: A total of 220 HD patients were prospectively assessed for fluid overload using the Fresenius body composition monitor (BCM)...
April 22, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29662810/clinical-results-of-arteriovenous-fistulas-constructed-using-autologous-vessels-in-end-stage-renal-disease-patients-on-hemodialysis
#9
Ki Tae Kim, Jae Wook Ryu, Pil Won Seo, Kyoung Min Ryu
Background: For hemodialysis patients with end-stage renal disease (ESRD), it is important to construct an efficient vascular access with a superior patency rate. This study investigated the factors influencing the efficiency of arteriovenous fistulas (AVFs) constructed using an autologous vessel and evaluated the necessity of ultrasonography as a preoperative tool for AVF construction. Methods: A retrospective analysis was performed of 250 patients in whom an AVF was constructed using an autologous vessel due to ESRD at our institution from January 2009 to April 2016...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29624859/comparison-between-open-and-pharmacomechanical-repair-of-acutely-thrombosed-arteriovenous-hemodialysis-fistulae-within-a-decade
#10
Susanne Regus, Veronika Almási-Sperling, Ulrich Rother, Alexander Meyer, Axel Schmid, Michael Uder, Werner Lang
INTRODUCTION: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single-center study was to compare immediate and follow-up results between surgical repair and a modified interventional lyse-and-wait technique characterized by prolonged local reaction times of recombinant tissue-plasminogen activator (rtPA). MATERIALS AND METHODS: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29615350/a-technique-for-the-salvage-of-megafistulas-allowing-immediate-dialysis-access
#11
Nosratollah Nezakatgoo, Steven D Kozusko, Jefferson T Watson, Rebecca Empting, Charles P Shahan, Michael J Rohrer
OBJECTIVE: Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS: The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602630/medicare-costs-associated-with-arteriovenous-fistulas-among-us-hemodialysis-patients
#12
Mae Thamer, Timmy C Lee, Haimanot Wasse, Marc H Glickman, Joyce Qian, Daniel Gottlieb, Scott Toner, Timothy A Pflederer
BACKGROUND: An arteriovenous fistula (AVF) is the recommended vascular access for hemodialysis (HD). Previous studies have not examined the resources and costs associated with creating and maintaining AVFs. STUDY DESIGN: Retrospective observational study. SETTING & PARTICIPANTS: Elderly US Medicare patients initiating hemodialysis therapy during 2010 to 2011. PREDICTOR: AVF primary and secondary patency and nonuse in the first year following AVF creation...
March 28, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29567027/a-prospective-randomized-study-of-bovine-carotid-artery-biologic-graft-and-expanded-polytetrafluoroethylene-for-permanent-hemodialysis-access
#13
Hanaa Dakour Aridi, Isibor Arhuidese, Melissa Scudder, Thomas Reifsnyder, Mahmoud B Malas
OBJECTIVE: Arteriovenous grafts (AVGs) remain reliable substitutes for permanent hemodialysis access in scenarios that preclude the placement of native arteriovenous fistulas (AVFs). The majority of AVGs are constructed of expanded polytetrafluoroethylene (ePTFE), which is relatively inexpensive and readily available, but synthetic AVGs have poor patency rates. On the other hand, biologic grafts confer an advantage by virtue of their inherent similarity to the native human vasculature...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29517177/basilic-vein-transposition-for-unsuitable-upper-arm-hemodialysis-needle-access-segment-may-attenuate-concurrent-hand-ischemia
#14
Michael W M Gerrickens, Roel H D Vaes, Bastiaan Govaert, Joep A W Teijink, Marc R Scheltinga
INTRODUCTION: Some hemodialysis patients with a brachial arteriovenous fistula (AVF) have an unsuitable upper arm needle access segment (NAS) necessitating basilic vein transposition (BVT). It was frequently observed that a portion of these patients spontaneously experienced a warmer and less painful dialysis hand after BVT. Aim of this study was to determine whether BVT for an inadequate NAS attenuated hemodialysis access-induced distal ischemia in patients with a brachial AVF. METHODS: Patients with a brachial AVF and an unsuitable NAS also reporting hand ischemia and scheduled to undergo BVT between 2005 and 2016 in a single facility were studied...
March 8, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29481943/technique-to-avoid-hemodialysis-catheter-in-patients-with-failing-aneurysmal-arteriovenous-fistula-by-creating-a-concomitant-new-arteriovenous-fistula
#15
Kelly A Lara, Rochelle Anne Chua, Trung D Vo
Autogenous arteriovenous fistula (AVF) is the primary recommended access for hemodialysis. Long-term use will not uncommonly result in AVF aneurysmal degeneration. Aneurysm-associated complications encompass pain, skin ulceration, infection, thrombosis, cannulation difficulties, and life-threatening bleeding. Various methods to repair aneurysmal AVFs have been described. However, there may be circumstances when this is not possible and require insertion of a temporary hemodialysis catheter (HDC) until a new arteriovenous access is created...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477679/flow-rates-at-thirty-days-after-construction-of-radiocephalic-arteriovenous-fistula-predict-hemodialysis-function
#16
Eric Pillado, Mina Behdad, Russell Williams, Samuel E Wilson
BACKGROUND: Construction of radiocephalic arteriovenous fistula (RC-AVF) results in successful hemodialysis (HD) in approximately 40% of end-stage renal disease patients. We investigated whether RC-AVF flow measured by ultrasound 30 days postoperative predicted successful HD. METHODS: In this prospective study, color Doppler ultrasound was used to measure cephalic vein outflow volume at 3 forearm sites at 1 and 3 months postoperatively. RESULTS: Of 45 consecutive patients screened for feasibility of RC-AVF by physical examination and US arterial and vein mapping, 41 were considered suitable for construction of RC-AVF...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477677/ultrasound-vein-and-artery-mapping-by-general-surgery-residents-during-initial-consult-can-decrease-time-to-dialysis-access-creation
#17
Kelsey Gray, Abraham Korn, Joshua Zane, Gabriel Gonzalez, Amy Kaji, Nina Bowens, Christian de Virgilio
BACKGROUND: Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended before hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. METHODS: This is a retrospective review of all patients who underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477675/factors-associated-with-early-thrombosis-after-arteriovenous-fistula-creation
#18
Abraham Korn, Hamid Alipour, Joshua Zane, Ali Shahverdiani, Timothy J Ryan, Amy Kaji, Nina Bowens, Christian de Virgilio
BACKGROUND: Arteriovenous fistulas (AVF) are the preferred modality for hemodialysis access. Early thrombosis hampers development of a working AVF. We endeavored to determine the incidence and identify factors associated with early thrombosis of AVF and to determine salvage rates following thrombosis, at a high-volume hemodialysis access center. METHODS: Retrospective review of autologous AVF was created between November 2014 and July 2016 at a single center. Early thrombosis was defined as thrombosis that occurred within 30 days of surgery...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477674/preoperative-antibiotics-for-dialysis-access-surgery-are-they-necessary
#19
Kelsey Gray, Abraham Korn, Joshua Zane, Hamid Alipour, Amy Kaji, Nina Bowens, Christian de Virgilio
BACKGROUND: Current guidelines recommend preoperative antibiotics in all vascular surgery cases. However, we hypothesize that patients undergoing arteriovenous fistula (AVF) and arteriovenous graft (AVG) creation have low rates of postoperative surgical site infection (SSI) and that preoperative antibiotic prophylaxis in these patients may not be necessary. METHODS: This is a retrospective review of all patients who underwent AVF and AVG creation from November 2014 through July of 2016 at a single institution...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29429750/arteriovenous-fistula-maturation-in-prevalent-hemodialysis-patients-in-the-united-states-a-national-study
#20
Kenneth J Woodside, Sarah Bell, Purna Mukhopadhyay, Kaitlyn J Repeck, Ian T Robinson, Ashley R Eckard, Sudipta Dasmunshi, Brett W Plattner, Jeffrey Pearson, Douglas E Schaubel, Ronald L Pisoni, Rajiv Saran
BACKGROUND: Arteriovenous fistulas (AVFs) are the preferred form of hemodialysis vascular access, but maturation failures occur frequently, often resulting in prolonged catheter use. We sought to characterize AVF maturation in a national sample of prevalent hemodialysis patients in the United States. STUDY DESIGN: Nonconcurrent observational cohort study. SETTING & PARTICIPANTS: Prevalent hemodialysis patients having had at least 1 new AVF placed during 2013, as identified using Medicare claims data in the US Renal Data System...
February 8, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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