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Central Vascular access

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https://www.readbyqxmd.com/read/28941744/comparison-of-manual-compression-and-vascular-hemostasis-devices-after-coronary-angiography-or-percutaneous-coronary-intervention-through-femoral-artery-access-a-meta-analysis-of-randomized-controlled-trials
#1
Khagendra Dahal, Jharendra Rijal, Ravi Shahukhal, Sharan Sharma, Hussam Watti, Michael Azrin, Pavan Katikaneni, Enrique Jimenez, Neeraj Tandon, Kalgi Modi, Juyong Lee
OBJECTIVES: To compare the efficacy and safety of manual compression (MC) with vascular hemostasis devices (VHD) in patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) through femoral artery access. INTRODUCTION: The use of femoral artery access for coronary procedures may result in access-related complications, prolonged immobility and discomfort for the patients. MC results in longer time-to-hemostasis (TTH) and time-to-ambulation (TTA) compared to VHDs but its role in access-related complications remains unclear in patients undergoing coronary procedures...
August 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28932593/successful-removal-of-embolized-chemoport-catheter-within-the-heart-and-pericardium-3-case-reports
#2
Shin-Eui Yoon, Chang Hoon Lee
Central venous access devices are routinely used in patients with cancer. Although rare, catheter transaction with subsequent embolization is one of the major complications of intra-vascular devices. We describe two patients with embolized chemoport catheters within the heart that were successfully removed percutaneously using a goose-neck snare technique. We also describe a third patient with a fractured intra-vascular catheter in the pericardium removed by pericardiotomy, which can be the first case of the kind...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#3
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#4
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28902743/use-of-an-alternative-surgical-corridor-in-oblique-lateral-interbody-fusion-at-the-l5-s1-segment-a-technical-report
#5
Nam-Su Chung, Chang-Hoon Jeon, Han-Dong Lee
STUDY DESIGN: Technical report. OBJECTIVE: To demonstrate the use of an alternative surgical corridor in oblique lateral interbody fusion (OLIF) at the L5-S1 segment. SUMMARY OF BACKGROUND DATA: OLIF L5-S1 is essentially performed through the central disk space between the bifurcations of the iliac vessels, which is sometimes difficult due to the vascular structures that obstruct the surgical field. Another concern is retrograde ejaculation following superior hypogastric plexus injury in male patients...
September 11, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28898528/post-transplant-oxygen-inhalation-improves-the-outcome-of-subcutaneous-islet-transplantation-a-promising-clinical-alternative-to-the-conventional-intrahepatic-site
#6
H Komatsu, J Rawson, A Barriga, N Gonzalez, D Mendez, J Li, K Omori, F Kandeel, Y Mullen
Subcutaneous tissue is a promising site for islet transplantation, due to its large area and accessibility, which allows minimally invasive procedures for transplantation, graft monitoring, and removal of malignancies as needed. However, relative to the conventional intrahepatic transplantation site, the subcutaneous site requires a large number of islets to achieve engraftment success and diabetes reversal, due to hypoxia and low vascularity. We report that the efficiency of subcutaneous islet transplantation in a Lewis rat model is significantly improved by treating recipients with inhaled 50% oxygen, in conjunction with prevascularization of the graft bed by agarose-bFGF...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#7
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28866629/strategies-to-reduce-line-infections-in-a-small-child-with-homozygous-familial-hypercholesterolaemia-who-cannot-yet-receive-ldl-apheresis
#8
Misan Lee, Janet Barr, Stewart Kribs, Guido Filler
Patients with homozygous familial hypercholesterolaemia are optimally treated with low-density lipoprotein apheresis. Young patients who do not meet a weight threshold (25 kg) receive regular plasmapheresis. This approach may remove excessive immunoglobulins and vascular access set-up can be challenging. We report the case of a 4 year-old child who exhibited repeated septic infections (5 in 6 months) and had recurrent access issues before two interventions were implemented: (1) the percutaneous central venous line was modified to two implanted paediatric ports, and (2) the patient started receiving two bags of Octaplasma at the end of each plasmapheresis treatment to account for the excessive loss of immunoglobulins...
September 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28865977/safety-and-efficacy-of-polyurethane-vascular-grafts-for-early-hemodialysis-access
#9
John D Kakisis, Constantine Antonopoulos, George Mantas, Evaggelos Alexiou, Konstantina Katseni, George Sfyroeras, Konstantinos Moulakakis, George Geroulakos
BACKGROUND: Arteriovenous grafts made of polyurethane (PU) have the advantage of early cannulation obviating the placement of a central vein catheter in patients with an acute need for long-term hemodialysis. The aim of the present study was to evaluate the safety, efficacy and complication rate of PU vascular grafts for dialysis access in patients in whom early cannulation was performed. METHODS: Between January 2007 and December 2015, 125 straight brachial-axillary grafts were placed in patients with an acute thrombosis of a previous arteriovenous access...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28854967/innovative-dressing-and-securement-of-tunneled-central-venous-access-devices-in-pediatrics-a-pilot-randomized-controlled-trial
#10
Amanda J Ullman, Tricia Kleidon, Victoria Gibson, Craig A McBride, Gabor Mihala, Marie Cooke, Claire M Rickard
BACKGROUND: Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure...
August 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28852577/sequential-venous-percutaneous-transluminal-angioplasty-and-balloon-dilatation-of-the-interatrial-septum-during-percutaneous-edge-to-edge-mitral-valve-repair
#11
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28847353/the-effect-of-education-on-chlorhexidine-use-in-the-nicu
#12
Janet Delong Pettit, Elizabeth Li Sharpe
BACKGROUND: Neonates are at greater risk for central line-associated bloodstream infection (CLABSI) because of prolonged vascular access for nutrition and medications. Skin antisepsis using chlorhexidine gluconate (CHG), particularly the formulation with alcohol (CHG/alcohol), during central line insertion and maintenance activities is a key clinical care process associated with CLABSI reduction. One area of ongoing confusion for many clinicians is whether to adhere to the manufacturer's recommendations that CHG remain on the skin following the procedure to promote persistent microbicidal effects or to foster product removal in hopes of preventing skin-related complications...
September 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#13
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28819317/intradialytic-central-venous-oxygen-saturation-is-associated-with-clinical-outcomes-in-hemodialysis-patients
#14
Lili Chan, Hanjie Zhang, Anna Meyring-Wösten, Israel Campos, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Central venous oxygen saturation (ScvO2) in the superior vena cava is predominantly determined by cardiac output, arterial oxygen content, and oxygen consumption by the upper body. While abnormal ScvO2 levels are associated with morbidity and mortality in non-uremic populations, ScvO2 has received little attention in hemodialysis patients. From 1/2012 to 8/2015, 232 chronic hemodialysis patients with central venous catheters as vascular access had their ScvO2 monitored during a 6-month baseline period and followed for up to 36 months...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28798220/vascular-access-type-and-clinical-outcomes-among-elderly-patients-on-hemodialysis
#15
Timmy Lee, Mae Thamer, Qian Zhang, Yi Zhang, Michael Allon
BACKGROUND AND OBJECTIVES: The optimal type of initial permanent access for hemodialysis among the elderly is controversial. Duration of central venous catheter dependence, patient comorbidities, and life expectancy are important considerations in whether to place an arteriovenous fistula or graft. We used an observational study design to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed...
August 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28797716/radiology-trainee-vs-faculty-radiologist-fluoroscopy-time-for-imaging-guided-procedures-a-retrospective-study-of-17-966-reports-over-a-5-5-year-period
#16
REVIEW
Ariadne K DeSimone, Andrew Post, Richard Duszak, Phuong-Anh T Duong
To evaluate differences in fluoroscopy time (FT) for common vascular access and gastrointestinal procedures performed by radiology trainees vs faculty radiologists. Report information was extracted for all 17,966 index fluoroscopy services performed by trainees or faculty, or both from 2 university hospitals over 66 months. Various vascular access procedures (eg, peripherally inserted central catheters [PICCs] and ports) and gastrointestinal fluoroscopy procedures (eg, upper gastrointestinal and contrast enema studies) were specifically targeted...
July 8, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28787431/right-or-left-side-selection-for-a-totally-implantable-vascular-access-device-a-randomised-observational-study
#17
Wen-Ying Lin, Chih-Peng Lin, Chih-Hung Hsu, Ying-Hui Lee, Yi-Ting Lin, Meng-Chi Hsu, Yu-Yun Shao
BACKGROUND: Totally implantable vascular access device (TIVAD)-related complications interfere in the anticancer treatment and increase medical expenses. We examined whether the implantation side of central line TIVADs is associated with the occurrence of thrombotic or occlusion events. METHODS: We enrolled patients with cancer who required central line TIVADs and randomised them to receive the TIVAD implantation on either the left or right side. The primary endpoint was the occurrence of catheter-related thrombotic or occlusion events...
August 8, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28785804/endovascular-creation-of-an-arteriovenous-fistula-endoavf-for-hemodialysis-access-first-results
#18
Christoph Georg Radosa, Julia Caroline Radosa, Norbert Weiss, Christine Schmidt, Sebastian Werth, Thomas Hofmockel, Verena Plodeck, Christian Gatzweiler, Michael Laniado, Ralf-Thorsten Hoffmann
INTRODUCTION: Surgical creation of a radiocephalic fistula is the gold standard of vascular access for hemodialysis. Recently, an endovascular approach for upper arm fistula creation (endoAVF) has been developed, which may be an alternative to open surgery. We describe a case series of eight cases showing feasibility, early complications and outcome of this novel treatment option. MATERIALS AND METHODS: Between July 2015 and February 2016, we created an endoAVF in eight patients...
August 7, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28782299/continuous-erythropoiesis-receptor-activator-cera-for-the-anaemia-of-chronic-kidney-disease
#19
REVIEW
Valeria M Saglimbene, Suetonia C Palmer, Marinella Ruospo, Patrizia Natale, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Continuous erythropoiesis receptor activator (CERA) is a newer, longer acting ESA which might be preferred to other ESAs (epoetin or darbepoetin) based on its lower frequency of administration. Different dosing requirements and molecular characteristics of CERA compared with other ESAs may lead to different health outcomes (mortality, cardiovascular events, quality of life) in people with anaemia and chronic kidney disease (CKD). OBJECTIVES: To assess benefits and harms of CERA compared with other epoetins (darbepoetin alfa and epoetin alfa or beta) or placebo/no treatment or CERA with differing strategy of administration for anaemia in individuals with CKD...
August 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28777415/repositioning-of-central-venous-access-devices-using-a-high-flow-flush-technique-a-clinical-practice-and-cost-review
#20
Timothy R Spencer
BACKGROUND: Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions.The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. METHODS: This is a Retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia...
August 2, 2017: Journal of Vascular Access
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