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arteriovenous graft fistula

Alice Luehr
Individuals who require renal replacement therapy overwhelmingly choose outpatient hemodialysis. Appropriate cannulation techniques are an essential element in access preservation and in the prevention of access-related complications. Missed cannulations can result in damage of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs). Ultrasound-guided cannulation is an effective technique for the placement of peripheral intravenous (IV) catheters and central venous catheters (CVCs) for hemodialysis. The purposes of this project were to determine if ultrasound-guided cannulation of AVFs decreased the number of missed cannulations, to determine staff and patient perceptions regarding cannulation, and to implement a quality incentive program (QIP) to implement an evidence-based ultrasound-guided policy and procedure, training program, and competency evaluation at a hospital-based dialysis facility...
September 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Konstantinos Tigkiropoulos, Dimitrios Karamanos, Kyriakos Stavridis, Nikolaos Zacharopoulos, Marianthi Tympanidou, Michalis Mantelas, Nikolaos Saratzis, Ioannis Lazaridis
Renal artery aneurysm with concomitant presence of arteriovenous fistula is an extremely rare entity. Few reports have been described in the literature. Nowdays endovascular repair with covered stents or transarterial embolization with coils or glue have become the first-line of treatment. We present the successful repair of a distal renal artery aneurysm combined with arteriovenous fistula with stent-graft.
October 1, 2018: Annals of Vascular Surgery
Ali Mirza Onder, Joseph T Flynn, Anthony A Billings, Fang Deng, Marissa DeFreitas, Chryso Katsoufis, Matthew M Grinsell, Larry T Patterson, Jennifer Jetton, Sahar Fathallah-Shaykh, Daniel Ranch, Diego Aviles, Lawrence Copelovitch, Eileen Ellis, Vimal Chanda, Ayah Elmaghrabi, Jen-Jar Lin, Lavjay Butani, Maha Haddad, Olivera Marsenic Couloures, Paul Brakeman, Raymond Quigley, H Stella Shin, Rouba Garro, Hui Liu, Javad Rahimikollu, Rupesh Raina, Craig B Langman, Ellen G Wood
BACKGROUND: Hemodialysis (HD) guidelines recommend permanent vascular access (PVA) in children unlikely to receive kidney transplant within 1 year of starting HD. We aimed to determine predictors of primary and secondary patency of PVA in pediatric HD patients. METHODS: Retrospective chart reviews were performed for first PVAs in 20 participating centers. Variables collected included patient demographics, complications, interventions, and final outcome. RESULTS: There were 103 arterio-venous fistulae (AVF) and 14 AV grafts (AVG)...
September 27, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Stephen J Raulli, Thomas W Cheng, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Douglas W Jones, Denis V Rybin, Matthew Nuhn, Amitabh Gautam, Jeffrey J Siracuse
BACKGROUND: There are conflicting data about the effect of heparin use on perioperative outcomes during upper extremity arteriovenous (AV) access creation. Our goal was to assess the effect of the use and degree of intraoperative heparin on perioperative outcomes after AV access creation. METHODS: All upper extremity AV access cases performed at a tertiary academic medical center between 2014 and 2017 were reviewed. Patient and procedural details including intraoperative heparin use and dosing as well as protamine use were analyzed...
September 11, 2018: Annals of Vascular Surgery
Birgit Steppich, Friederike Schürmann, Olga Bruskina, Martin Hadamitzky, Adnan Kastrati, Heribert Schunkert, Massimiliano Fusaro, Ilka Ott
BACKGROUND: Increasing volume of complex percutaneous endovascular procedures in highly anticoagulated patients generate a not negligible percentage of femoral pseudoaneurysms (PSA) with concomitant arteriovenous fistulas (AVF). While ultrasound-guided thrombin injection (UGTI) is the therapy of choice for PSA, concomitant AVF is regarded as a contraindication for UGTI, as venous thromboembolism is feared. In this retrospective, register-based cohort study, we report on and evaluate the use of UGTI for the treatment of PSA with AFV...
September 3, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Jacentha Buggs, Adam Tanious, Victor Camba, Christopher Albertson, Ebonie Rogers, Dylan Lahiff, Talha Rashid, John Leone, Heidi Pearson, James Huang, Ambuj Kumar, Victor Bowers
BACKGROUND: The use of autologous arteriovenous fistulae (AVF) for hemodialysis (HD) is the gold standard; however, for many patients at tertiary referral centers, this is not an option. METHODS: We conducted a four year retrospective cohort study to evaluate HD access outcomes with AVF, bovine carotid artery (BCA), and polytetrafluoroethylene arteriovenous graft (PTFE). RESULTS: The study contained 416 AVF, 175 BCA, and 58 PTFE, N = 649...
August 21, 2018: American Journal of Surgery
Zaghloul Elsafy Gouda, Mahmoud Mohamed Emara, Hany Said Elbarbary, Mahmoud Abdel Aziz Koura, Ahmed Rabie Elarbagy
INTRODUCTION: Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view. METHOD: The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion...
August 24, 2018: Journal of Vascular Access
Hunbo Shim, Dong Seop Jeong, Wook Sung Kim, Pyo Won Park, Kiick Sung, Chang Seok Jeon, Young Tak Lee
BACKGROUND: This study compared clinical outcomes between the use of in situ and free internal thoracic artery grafts in patients with upper extremity arteriovenous fistula who underwent coronary artery bypass. METHODS: We reviewed 85 hemodialysis-dependent patients with upper extremity arteriovenous fistula who underwent coronary artery bypass with internal thoracic artery grafts. The patients were categorized into two groups; 48 (56%) with in situ graft ipsilateral to the arteriovenous fistula (Group I) and 37 (44%) with free grafts anastomosed to the ascending aorta (Group F)...
August 14, 2018: Annals of Thoracic Surgery
Takehisa Nojima, Yasuki Motomiya
Objective : Flow reduction is required to preserve vascular access in cases with high flow access (HFA). We report a new flow reduction procedure, the graft inclusion technique (GIT). Methods : The GIT procedure developed by us involves the intraluminal placement and suturing of a 4-mm polytetrafluoroethylene graft to the anastomosis and outflow tract to plicate the enlarged anastomosis and maintain lower flow volumes. Flow reduction for HFA was retrospectively assessed in a series of 25 patients (age 65±12 years; 17 males and 8 females) to evaluate flow volume and patency rate, wherein 10 patients underwent conventional methods of flow reduction and 15 underwent GIT...
June 25, 2018: Annals of Vascular Diseases
Gang Jee Ko, Connie M Rhee, Yoshitsugu Obi, Tae Ik Chang, Melissa Soohoo, Tae Woo Kim, Csaba P Kovesdy, Elani Streja, Kamyar Kalantar-Zadeh
Background: Arteriovenous fistulas (AVFs) are the preferred vascular access type in most hemodialysis patients. However, the optimal vascular access type in octogenarians and older (≥80 years) hemodialysis patients remains widely debated given their limited life expectancy and lower AVF maturation rates. Methods: Among incident hemodialysis patients receiving care in a large national dialysis organization during 2007-2011, we examined patterns of vascular access type conversion in 1 year following dialysis initiation in patients <80 versus ≥80 years of age...
August 9, 2018: Nephrology, Dialysis, Transplantation
H Tarık Kızıltan
Patients who have aortoiliac aneurysms with arteriovenous fistulas are difficult to treat. The traditional mode of surgical repair based on aneurysmal excision, fistula closure and graft inclusion has been associated with high perioperative mortality. As an alternative the exclusion technique has also been utilized. Over the years the popularity and success rate of endovascular techniques have increased in the treatment of these patients, yet a technical failure during an endovascular repair always makes surgical repair inevitable...
July 26, 2018: Heart Surgery Forum
Rebecca D Levit
Blood vessels convey essential nutrients to end organs, and when diseased, they must be replaced or bypassed. Traditionally plastic and synthetic materials have been used but are susceptible to thrombosis, stenosis, and poor patency rates. A recent report in Science Translational Medicine describes a decellularized matrix grown in vitro from commercially sourced fibroblasts that can be used as a vascular graft. Fibroblasts are grown for several weeks on a fibrin scaffold, laying down a collagen layer. After decellularization and transplantation as an arteriovenous fistula, this group showed that grafts remained patent for several weeks...
February 2018: JACC. Basic to Translational Science
D Kamińska, M Łukaszewski, N Kozera, K Kościelska-Kasprzak, D Bartoszek, O Mazanowska, W Goździk, P Chudoba, P Zaleska, A Lepiesza, M Klinger
Previously transplanted highly sensitized patients experience problems with subsequent transplantation. It is also difficult to provide optimal hemodynamic conditions during successive kidney transplantation in heart transplant recipients. PATIENT AND METHODS: We present a case of a 56-year old patient with end-stage renal failure after heart transplantation performed 21 years ago and hemodialyzed using arteriovenous fistula. The patient had 69% panel-reactive antibodies, had been on the active waiting list since 2013, and presented 335 positive crossmatches with deceased donors...
July 2018: Transplantation Proceedings
K Letachowicz, T Królicki, K Bardowska, A Drabik, K Zajdel, D Kamińska, K Madziarska, M Banasik, O Mazanowska, M Krajewska, M Klinger
INTRODUCTION: The prevalence of hypertension in renal graft recipients is high. It was postulated that central arteriovenous anastomosis may significantly reduce blood pressure. This preliminary study evaluates the impact of functioning arteriovenous fistula (AVF) on blood pressure control and renal allograft function. MATERIALS AND METHODS: One hundred sixty-two previously hemodialyzed kidney transplant recipients (108 males, 54 females, aged 52.7 ± 13.2 years, mean 6...
July 2018: Transplantation Proceedings
Seun Deuk Hwang, Jin Ho Lee, Seoung Woo Lee, Joong Kyung Kim, Moon-Jae Kim, Joon Ho Song
BACKGROUND: The benefit of access flow surveillance in preventing vascular access thrombosis and failure remains controversial, as many randomized clinical trials (RCTs) have failed to demonstrate consistent results. The aim of this study was to perform a meta-analysis including newly published RCTs with a subgroup analysis for arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs). METHODS: A systematic review of the available literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
July 2018: Medicine (Baltimore)
Scott O Trerotola, Jeffrey Lawson, Prabir Roy-Chaudhury, Theodore F Saad
BACKGROUND: Restenosis remains a problem in hemodialysis access interventions. Paclitaxel-coated balloons have shown promise in reducing access-related restenosis in small trials. The primary hypotheses for our multicenter trial were superior effectiveness at 180 days and noninferior safety at 30 days of a drug-coated balloon compared with conventional angioplasty for treatment of dysfunctional arteriovenous fistulas. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This randomized trial enrolled 285 patients with dysfunctional arteriovenous fistulas at 23 centers...
August 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Farah Gillan Irani, Terence Kiat Beng Teo, Kiang Hiong Tay, Win Htet Yin, Hlaing Hlaing Win, Apoorva Gogna, Ankur Patel, Chow Wei Too, Shaun Xavier Ju Min Chan, Richard Hoau Gong Lo, Luke Han Wei Toh, Siew Ping Chng, Hui Lin Choong, Bien Soo Tan
Purpose To compare lesion primary patency and restenosis rates between drug-eluting balloon (DEB) percutaneous transluminal angioplasty (PTA) and conventional balloon PTA (cPTA) in the treatment of arteriovenous fistula (AVF) and arteriovenous graft (AVG) stenosis. Materials and Methods In this prospective study, 119 participants (mean age, 59.2 years; 79 men, 40 women) with failing AVFs (n = 98) or AVGs (n = 21) were randomly assigned to undergo either DEB PTA (n = 59) or cPTA (n = 60) from January 2012 to May 2013...
October 2018: Radiology
Jayakumar Sreenivasan, Muhammad Ayub, Neha Yadav, Yasmeen Golzar
Iatrogenic aortocoronary arteriovenous fistula is a very rare complication of coronary artery bypass grafting in which one of the arterial grafts inadvertently forms a fistulous tract with a cardiac vein, shunting blood from the anastomosed coronary artery. We report a patient with an iatrogenic left internal mammary artery graft to cardiac vein fistula presenting with recurrent angina three years after a three-vessel coronary artery bypass grafting.
2018: Case Reports in Cardiology
C Del Giudice, D Van Den Heuvel, J Wille, T Mirault, E Messas, R Ferraresi, S Kum, M Sapoval
PURPOSE: To report our initial experience of fully percutaneous deep venous arterialization (pDVA) for the treatment of chronic critical limb ischemia (cCLI) after failed distal angioplasty. MATERIALS AND METHODS: pDVA was performed in five consecutive patients by creating an arteriovenous fistula (AVF) between a below the knee artery and its satellite deep vein. In this early experience, only patients with failed prior interventional attempts at establishing flow with no distal targets for an arterial bypass were selected...
October 2018: Cardiovascular and Interventional Radiology
Pauline Vanderweckene, Laurent Weekers, Patrizio Lancellotti, François Jouret
Arteriovenous fistula (AVF) is regarded as the best vascular access for chronic haemodialysis (HD). Still, AVF inherently causes significant haemodynamic changes. Although the necessity for vascular access despite its putative cardiovascular complications favours AVF creation in patients under chronic HD, one may question whether sustaining a functional AVF after successful kidney transplantation extends the haemodynamic threat. Small prospective series suggest that AVF ligation causes rapid and sustained reduction in left ventricular hypertrophy...
June 2018: Clinical Kidney Journal
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