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arteriovenous graft fistula

Timmy Lee, Joyce Qian, Mae Thamer, Michael Allon
BACKGROUND: Despite national vascular access guidelines promoting the use of arteriovenous fistulas (AVF) over arteriovenous grafts (AVGs) for dialysis, AVF use is substantially lower in females. We assessed clinically relevant AVF and AVG surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). METHODS: Using the United States Renal Data System standard analytic files linked with Medicare claims, we assessed incident hemodialysis patients in the United States, 9,458 elderly patients (≥67 years; 4,927 males and 4,531 females) initiating hemodialysis from July 2010 to June 2011 with a catheter and had an AVF or AVG placed within 6 months...
December 13, 2018: American Journal of Nephrology
Deokbi Hwang, Sujin Park, Hyung-Kee Kim, Seung Huh
OBJECTIVE: The advantage of arteriovenous fistulas (AVFs) in older patients requiring dialysis is controversial. We reviewed our vascular access experience in patients ≥70 years of age (older group) compared with younger patients. METHODS: We analyzed consecutive patients who underwent access surgery between 2013 and 2016. Primary success (PS) and primary patency (PP) data were analyzed between the older and younger groups before and after propensity score matching of the patients' characteristics and access composition...
October 24, 2018: Journal of Vascular Surgery
Johannes W Drouven, Cor de Bruin, Arie M van Roon, Job Oldenziel, Clark J Zeebregts
BACKGROUND: Radial-cephalic arteriovenous fistula and brachial-cephalic arteriovenous fistula are the first and second choices for creating vascular access in dialysis patients as recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Basilic vein transposition or use of a forearm (polytetrafluoroethylene [PTFE]) loop graft is recommended thereafter. The aim of this study was twofold: first, to compare the outcomes and patency rates of patients treated with a basilic vein transposition with those of patients treated with a PTFE loop; and second, to identify patient-related factors of influence on patency rates...
October 24, 2018: Journal of Vascular Surgery
Monica L Schoch, Judy Currey, Liliana Orellana, Paul N Bennett, Vicki Smith, Alison M Hutchinson
Background: Point-of-care ultrasound (POCUS) has been used in various vascular access contexts; however, to date, it has not been widely adopted in haemodialysis clinics. People with end-stage kidney disease receiving haemodialysis require an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous access device (CVAD) in order to access their blood for therapy/treatment. Cannulation issues, such as haematoma and extravasation, related to AVFs and AVGs are common. This pilot and feasibility study will assess the feasibility of a randomised controlled trial aimed at evaluating whether POCUS-guided cannulation results in more successful and accurate AVF needle placement than the standard practice of blind cannulation...
2018: Pilot and Feasibility Studies
Reuban Toby D'cruz, Sze Wai Leong, Nicholas Syn, Alok Tiwari, Vikram Vijayan Sannasi, Harvinder Raj Singh Sidhu, Tjun Yip Tang
PURPOSE: The aim of this study is to appraise the current literature on the endovascular management options and their outcomes of cephalic arch stenosis in the setting of a failing brachiocephalic fistula for hemodialysis. METHODS: A systematic search of the literature was performed using PubMed, Embase, and Google Scholar from January 2000 to December 2017 in accordance with the PRISMA guidelines to investigate the outcomes of endovascular management of cephalic arch stenosis...
December 3, 2018: Journal of Vascular Access
Dilsad Amanvermez Senarslan, Funda Yildirim, Omer Tetik
Aneurysms of the upper extremity mostly originate from trauma, mycotic lesions, thoracic outlet syndrome, previous arteriovenous fistulae and atherosclerosis. True aneurysms of the brachial and axillary artery are encountered rarely. They can be diagnosed by simple physical examination as a pulsatile mass. However, most of these aneurysms remain asymptomatic until a complication occurs. The primary complication seen with the axillary or brachial artery is embolization. We report three large diameter true brachial artery aneurysms extending to the axillary zone...
November 26, 2018: Annals of Vascular Surgery
Ka-Wai Tam, Mei-Yi Wu, Fahad Javaid Siddiqui, Edwin Sy Chan, Yanan Zhu, Tazeen H Jafar
BACKGROUND: Maintaining long-term vascular access patency is necessary for high quality haemodialysis (HD) treatment of patients with the terminal and most serious stage of chronic kidney disease (CKD) - end-stage kidney disease (ESKD). Oral supplementation with omega-3 fatty acids (ω-3FA) may help to prevent blockage of the vascular access by reducing the risk of thrombosis and stenosis. OBJECTIVES: To evaluate the efficacy and safety of ω-3FA supplementation versus placebo or no treatment for maintaining vascular access patency in ESKD patients undergoing HD...
November 18, 2018: Cochrane Database of Systematic Reviews
Lalathaksha Kumbar, Ed Peterson, Matthew Zaborowicz, Anatole Besarab, Jerry Yee, Gerard Zasuwa
BACKGROUND AND OBJECTIVES: The vascular access pressure ratio test identifies dialysis vascular access dysfunction when three consecutive vascular access pressure ratios are >0.55. We tested whether the magnitude of the decline in vascular access pressure ratio 1-week post-intervention could alert of subsequent access failure. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: The retrospective study included all vascular access procedures at one institution from March 2014 to June 2016...
November 27, 2018: Journal of Vascular Access
Anastasia Plotkin, Matthew G Bartley, Kathryn E Bowser, Jeniann A Yi, Omid Jazaeri, Gregory A Magee
INTRODUCTION: Iliofemoral vein thrombosis can lead to debilitating edema and venous claudication that significantly worsens quality of life, especially in young active individuals. Venous reconstruction becomes increasingly complex and has worsening patency with subsequent revisions so preoperative planning is critical to success. METHODS: We report a case of a 54 year-old man in active military service with profoundly symptomatic leg swelling after failure of three previous common femoral vein (CFV) reconstructions...
November 23, 2018: Annals of Vascular Surgery
Pei Yi Fan, Cheng Chia Lee, Shou Hsuan Liu, I-Jung Li, Cheng Hao Weng, Kun Hua Tu, Mei Yun Hsieh, Chang Fu Kuo, Ting-Yu Chang, Ya Chung Tian, Chih Wei Yang, Hsin Hsu Wu
BACKGROUND: Dialysis adequacy is a major determinant of survival for patients with end-stage renal disease. Good vascular access is essential to achieve adequate dialysis. OBJECTIVES: This study evaluated the impacts of different drugs on the vascular access failure rate of an arteriovenous fistula or an arteriovenous graft and the rate of major bleeding in hemodialysis patients. PATIENTS AND METHODS: We studied patients with end-stage renal disease registered in the Taiwan National Health Insurance program from January 1, 1997 to December 31, 2012...
November 25, 2018: Journal of Thrombosis and Haemostasis: JTH
Sheng-Hong Shi, Tien-Jen Chen
Percutaneous transluminal angioplasty (PTA) is the most common therapy used to treat dialysis patients with an occluded arteriovenous fistula (AVF) or arteriovenous graft (AVG). AVF or AVG hemostasis after PTA is time consuming, and it may be complicated with acute thrombosis of the AVF or AVG and re-bleeding from the puncture site. In this study, we prospectively studied 145 hemodialysis patients with occluded AVF or AVG using a modified purse-string suture with short tubing tourniquet technique for hemostasis following PTA, during which we used heparin and urokinase infusion...
November 2018: Acta Cardiologica Sinica
Steve J A Majerus, Thomas Knauss, Soumyajit Mandal, Geoff Vince, Margot S Damaser
Subjective analysis of bruits has long been an element of vascular access physical exams. Digital recordings of blood flow bruits-phonoangiograms (PAGs)-may provide an objective, non-imaging measure of vascular access stenosis. We have analyzed the long-term stability in PAGs from typical dialysis patients with arteriovenous fistulas and grafts and found that typical patients have correlated PAG spectra. PAGs can be analyzed using nonlinear, sub-band frequency-domain linear prediction to produce both bruit-enhanced recordings and a bruit-enhanced power envelope...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Li-Jun Yan, Fei-Ran Zhang, Chan-Shan Ma, Yang Zheng, Jun-Tian Chen, Wei Li
BACKGROUND: Arteriovenous grafting offers an alternative for patients whose vessels are unsuitable for arteriovenous fistula. However, as a result of subcutaneous tunnel dissection, postoperative pain and edema of the operated limb present early after surgery. As a traditional therapeutic approach, cryotherapy has the ability to suppress postoperative pain and edema. AIMS: The purpose of the study was to investigate the feasibility of cryotherapy after arteriovenous graft surgery to decrease perioperative medication usage...
November 10, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Eunjin Bae, Hajeong Lee, Dong Ki Kim, Kook-Hwan Oh, Yon Su Kim, Curie Ahn, Jin Suk Han, Sang-Il Min, Seung-Kee Min, Hyo-Cheol Kim, Kwon Wook Joo
BACKGROUND: The number of elderly patients with end-stage renal disease is increasing rapidly. The higher prevalence of comorbidities and shorter life expectancy in these patients make it difficult to decide on the type of vascular access (VA). We explored the optimal choice for VA in elderly hemodialysis patients. METHODS: We included elderly patients (> 65 years) visiting our VA clinic and divided them into three groups as follows: radiocephalic arteriovenous fistula (AVF), brachiocephalic AVF, and prosthetic arteriovenous graft (AVG)...
November 6, 2018: BMC Nephrology
Eugene Lin, Matthew W Mell, Wolfgang C Winkelmayer, Kevin F Erickson
BACKGROUND AND OBJECTIVES: Patients without Medicare who develop ESKD in the United States become Medicare eligible by their fourth dialysis month. Patients without insurance may experience delays in obtaining arteriovenous fistulas or grafts before obtaining Medicare coverage. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this retrospective cohort study, we used a national registry to compare uninsured patients starting in-center hemodialysis with a central venous catheter between 2010 and 2013 with similar patients with Medicare or Medicaid...
November 1, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Ziming Wan, Qiquan Lai, Bo Tu
BACKGROUND: Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. We report a case of a patient who restarted hemodialysis after his second kidney graft failure using a long-discarded autologous arteriovenous fistula. CASE PRESENTATION: A 62-year-old man was diagnosed with end-stage renal disease 20 year ago, and a native arteriovenous fistula was created for hemodialysis. After the patient received his first kidney transplantation, the hemodialysis fistula was discarded and chronically thrombosed for 13 years...
October 26, 2018: BMC Nephrology
Jeeeun Park, Jinhae Kim, Subin Hwang, Mi Kyoung Lee, Hye Ryoun Jang, Jung Eun Lee, Yang-Jin Park, Wooseong Huh, Yoon-Goo Kim, Ha Young Oh, Dae Joong Kim
OBJECTIVES: Arteriovenous graft for hemodialysis shows poorer outcomes than arteriovenous fistula, due to frequent stenosis and thrombosis. We investigated arteriovenous graft patency outcomes and prognostic factors for these outcomes. METHODS: We included a single-center cohort of patients receiving arteriovenous graft for hemodialysis access from 2010 to 2014. Demographics, laboratory data, comorbidities, and medications were collected from medical records. Surgical factors related to graft operation including the type and diameter of connected vessels, graft location, and type of operation (elective or emergency) were also recorded...
October 26, 2018: Vascular
Samantha J McEwan, Hannah Maple, Paul J Gibbs
INTRODUCTION: Definitive access in patients requiring renal replacement therapy is an ever-increasing challenge. For those where autogenous venous access is no longer a viable option, arteriovenous grafts can be considered. This article describes long-term follow-up, complications and patency rates of the mid-thigh 'adductor loop' arteriovenous graft. METHODS: 50 mid-thigh loop arteriovenous grafts have been inserted into 48 patients in our unit over the past 11 years...
October 22, 2018: Journal of Vascular Access
Matthew G Brown, Nicholas Dugan, Laura C Lamb
INTRODUCTION: Autogenous arteriovenous fistula (AVF) creation is the gold standard of hemodialysis access. However, autologous upper extremity arteriovenous fistulae continue to present significant clinical challenges including failure to mature and steal syndrome. We describe treating a patient with dialysis-associated steal syndrome (DASS) by ligating and then transposing a well-developed, mature upper arm cephalic vein AVF into the contralateral arm. CASE DESCRIPTION: Our patient is a 76 year old female with end stage renal disease (ESRD) secondary to glomerulonephritis, who had a left arm brachiocephalic AVF created in 2007...
October 17, 2018: Annals of Vascular Surgery
Michael D Sgroi, Graeme McFarland, Nathan K Itoga, Ehab Sorial, Manuel Garcia-Toca
BACKGROUND: Limited reports have documented the effect cardiac implantable electronic devices (CIEDs) have on arteriovenous (AV) access patency. Current recommendations suggest placing the access on the contralateral side of the CIEDs, as there is concern for increased central venous stenosis and access failure. The goal of this study is to review our single-center AV access patency rates for dialysis patients with an ipsilateral or contralateral side CIED. METHODS: A retrospective review was performed from 2008 to 2016 at a single institution identifying all patients who have received a CIED and the diagnosis of end-stage renal disease (ESRD)...
October 17, 2018: Annals of Vascular Surgery
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