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Central Vascular access

Silvi Shah, Anthony C Leonard, Karthikeyan Meganathan, Annette L Christianson, Charuhas V Thakar
BACKGROUND: Arteriovenous (AV) access confers survival benefits over central venous catheters (CVC) in hemodialysis patients. Although chronic kidney disease disproportionately affects women and racial minorities, disparities in the -utilization of hemodialysis access across Asians, Native Americans, Hispanics, blacks, and whites among males and females after accounting for pre-dialysis health are not well studied. METHODS: We evaluated 885,699 patients with end-stage renal disease who initiated hemodialysis between January 1, 2004 and December 31, 2014 using the US Renal Data System...
July 10, 2018: American Journal of Nephrology
Kouying Liu, Ye Zhou, Weiping Xie, Zejuan Gu, Yu Jin, Xinhua Ye, Xuesong Chen, Boqiang Fan, Hong Wang, Yan Cui
BACKGROUND: Peripherally-inserted central catheter-related venous thrombosis has serious complications including the loss of vascular access, recurrent venous thrombosis, and post-thrombotic syndrome. Current guidelines recommend non-pharmacological strategies to prevent peripherally-inserted central catheter-related venous thrombosis. There is little evidence for the effectiveness of handgrip exercise on the prevention of peripherally-inserted central catheter-related venous thrombosis...
June 22, 2018: International Journal of Nursing Studies
Alvin P Chan, Pamela S Baldivia, Laurie E Reyen, Alissa N Lund, Elizabeth A Marcus, Robert S Venick, Jorge H Vargas, Laura J Wozniak
PURPOSE: Damaged central venous catheters (CVCs) are commonly repaired to avoid line replacement and preserve vascular access. However, limited data suggest an increased risk for central line-associated bloodstream infections (CLABSIs) associated with the repair procedure. The purpose of this study was to describe outcomes of CVC repairs among parenteral nutrition (PN) dependent children with intestinal failure (IF). METHODS: A 2-year retrospective review was performed on children with IF on home PN > 6 months...
June 9, 2018: Journal of Pediatric Surgery
Brandon Budhram, Ayub Akbari, Pierre Brown, Mohan Biyani, Gregory Knoll, Deborah Zimmerman, Cedric Edwards, Brendan McCormick, Ann Bugeja, Manish M Sood
Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, with afflicted patients often progressing to end-stage kidney disease (ESKD) requiring renal replacement therapy (RRT). As the timelines to ESKD are predictable over decades, it follows that ADPKD patients should be optimized regarding kidney transplantation, home dialysis therapies, and vascular access. Objectives: To examine the association of kidney transplantation, dialysis modalities, and vascular access in ADPKD patients compared with a matched, non-ADPKD cohort...
2018: Canadian Journal of Kidney Health and Disease
Andrew Robinson, Osama Souied, A Brianne Bota, Nathalie Levasseur, Carol Stober, John Hilton, Dalia Kamel, Brian Hutton, Lisa Vandermeer, Sasha Mazzarello, Anil A Joy, Dean Fergusson, Sheryl McDiarmid, Mathew McInnes, Risa Shorr, Mark Clemons
IMPORTANCE: Systemic chemotherapy can be administered either through a peripheral vein (IV), or centrally through peripherally inserted central catheter (PICC), totally implanted vascular access devices (PORTs) or tunnelled cuffed catheters. Despite the widespread use of systemic chemotherapy in patients with breast cancer, the optimal choice of vascular access is unknown. OBJECTIVE: This systematic review evaluated complication rates and patient satisfaction with different access strategies for administering neo/adjuvant chemotherapy for breast cancer...
July 4, 2018: Breast Cancer Research and Treatment
L Ciércoles Ramírez, M Batllori Gastón, M E García Tinoco
Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel...
June 26, 2018: Anales del Sistema Sanitario de Navarra
Michelle Gompelman, Yannick Wouters, Wietske Kievit, Joost Hopman, Heiman F Wertheim, Chantal P Bleeker-Rovers, Geert J A Wanten
BACKGROUND: Patients with long-term intestinal failure are usually treated by means of home parenteral nutrition (HPN) where they administer their nutritional formulation intravenously via a central venous access device (mostly a catheter). This implies that such patients are exposed to a lifelong risk of developing Staphylococcus aureus bacteremia (SAB). SAB poses a threat to both catheter and patient survival and may lead to frequent hospitalization and a permanent loss of vascular access...
June 28, 2018: Trials
Anubhav Bussooa, Steven Neale, John R Mercer
Cardiovascular disease remains the leading cause of death in Western society. Recent technological advances have opened the opportunity of developing new and innovative smart stent devices that have advanced electrical properties that can improve diagnosis and even treatment of previously intractable conditions, such as central line access failure, atherosclerosis and reporting on vascular grafts for renal dialysis. Here we review the latest advances in the field of cardiovascular medical implants, providing a broad overview of the application of their use in the context of cardiovascular disease rather than an in-depth analysis of the current state of the art...
June 22, 2018: Sensors
Ray Hachem, Souha Kanj, Nelson Hamerschlak, Hala Saad, Fernanda Ferraz Assir, Nobuyoshi Mori, Ying Jiang, Fady Ghaly, Anne Marie Chaftari, Issam I Raad
BACKGROUND: The use of long-term central venous catheters (CVCs) could lead to serious bloodstream infections. Removal of the infected CVC and reinsertion of a new CVC are not always feasible and alternative lock therapy may be considered. We conducted a multicenter trial to assess the efficacy and safety of the lock therapy. METHODS: Between October 2013 and August 2014, we prospectively enrolled 20 patients with catheter-related bloodstream infections (CRBSIs) or central line-associated bloodstream infections (CLABSIs) in our sister institutions in three countries including Brazil, Lebanon, and Japan...
June 2018: Expert Review of Medical Devices
Shanshan Wu, Wanjiao Li, Qiongxiao Zhang, Shuting Li, Lizi Wang
AIM: To compare peripheral arm ports versus central chest ports in complication rates. BACKGROUND: Late complications of arm ports versus chest ports, including catheter-related infection, venous thrombosis and catheter obstruction, remain controversial. DESIGN: A meta-analysis conducted following the Cochrane handbook. DATA SOURCES: Studies published between 1950 - August 2017 were searched through Pubmed, Embase, Web of science and Cochrane library...
June 19, 2018: Journal of Advanced Nursing
Céline Bridey, Nathalie Thilly, Thomas Lefevre, Adeline Maire-Richard, Maxime Morel, Bruno Levy, Nicolas Girerd, Antoine Kimmoun
OBJECTIVE: Establishing a peripheral intravenous catheter (PIVC) after a long intensive care unit (ICU) stay can be a challenge for nurses, as these patients may present vascular access issues. The aim of this study was to compare an ultrasound-guided method (UGM) versus the landmark method (LM) for the placement of a PIVC in ICU patients who no longer require a central intravenous catheter (CIVC). DESIGN: Randomised, controlled, prospective, open-label, single-centre study...
June 9, 2018: BMJ Open
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
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
Anatole Besarab, Lalathaksha Kumbar
A one-size-fits-all approach to vascular access for dialysis may be prejudicial. Arteriovenous fistulae (AVF) have high primary failure, failure to mature rate, and late-stage complications making them unsuitable choice for many patients. Aging of population with chronic kidney disease (CKD) coupled with venous injury during CKD stages depletes suitable superficial veins for AVF creation. The National Institutes of Health consortium demonstrated the difficulty in attaining a functional AVF in hemodialysis patients...
June 1, 2018: Seminars in Dialysis
Kimberlee B Chenoweth, Jia-Wen Guo, Belinda Chan
BACKGROUND: Establishing vascular access is a common neonatal intensive care unit procedure. The extended dwell peripheral intravenous (EPIV) catheter is a 6-cm and 8-cm silicone catheter for peripheral vein insertion, which is a newer vascular access device than peripherally inserted central catheters (PICCs) and peripheral intravenous (PIV) catheter. Extended dwell peripheral intravenous catheters have been widely used in adults but evidence in neonates is lacking. PURPOSE: To explore indwell time, success rate, catheter-associated complications, and cost among EPIV catheters, PICCs, and PIV catheters in neonates...
May 28, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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
W Xiong, L E Wang, Y Liu, Z Peng, J Xie, S S Gong
Objective: To observe the clinical effect on the treatment of intractable tympanitis with reconstruction of external auditory canal wall. Method: Five cases underwent radical removel of residual lesion and reconsruction of external auditory posterior canal wall using hydroxyapatite ceramic wall with transferred pedicle temporalis fascia covering on it were analyzed. The implement of ossicular chain reconstruction depends on the probing for tympanic cavity intraoperatively. Periodic review were conducted in the 1st, 3rd, 6th, 12th month after surgery...
August 20, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Ye He, Xin-Jun Ren, Bo-Jie Hu, Wai-Ching Lam, Xiao-Rong Li
BACKGROUND: This meta-analysis evaluated the effectiveness and safety of dexamethasone (DEX) implant and intravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). METHODS: The PubMed, Embase, website and Cochrane Library databases were comprehensively searched for studies comparing DEX implant with anti-VEGF in patients with DME. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and adverse events were extracted from the final eligible studies...
May 21, 2018: BMC Ophthalmology
Nalaka Gunawansa, Dinesha Himali Sudusinghe, Dilushi Rowena Wijayaratne
Central venous catheter (CVC) use is common among patients undergoing hemodialysis. Catheter-related vascular thrombosis is a frequent complication, which results in catheter dysfunction. This may eliminate the affected vein as a potential route of vascular access and leads to significant morbidity of the limbs involved. Despite increasing prevalence, there is a dearth of evidence-based guidelines for managing such catheter-related thrombi, often leading to treatment dilemmas in clinical practice. Minimizing the use of CVCs for hemodialysis remains the best approach in preventing such adverse complications...
May 29, 2018: Annals of Vascular Surgery
Mikhail Cherkashin, Natalia Berezina, Denis Puchkov, Kirill Suprun, Petr Yablonsky
Totally implanted venous access port (TIVAP) systems provide adequate quality of care and life, especially for oncology patients. Long-term vascular access is very important and easy to perform, but in some clinical situations, if patients have a superior caval system occlusion, femoral insertion may be the only option. We present a case of a 70-year-old colorectal adenocarcinoma patient diagnosed with subclavian vein hypoplasia. Her care team decided intraoperatively to implant a port system by the right femoral access...
March 14, 2018: Curēus
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