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hemodialysis vascular access

Takashi Uchino, Hiromasa Nakai, Hiroaki Ichihashi, Tsukasa Sasaki, Nakanobu Azuma
Preoperative ultrasound vascular mapping was performed to determine the surgical method for two cases where standard arteriovenous fistula was not possible. In case 1, the previous arteriovenous fistula of the left arm was occluded, and arteriovenous graft of the right arm was thrombosed after frequent percutaneous transluminal angioplasty. Contrast medium was contraindicated because of allergy. Using preoperative ultrasound vascular mapping, we were able to establish the appropriate surgical method. In case 2, hemodialysis was started by catheter insertion, and then access creation was planned...
March 1, 2018: Journal of Vascular Access
Matt Chiung-Yu Chen, Mei-Jui Weng, Huei-Lung Liang
PURPOSE: This study was performed to retrospectively assess the efficacy of percutaneous creation of an intervascular bypass with or without stent graft deployment (endovascular bypass) for salvage of abandoned vascular access sites in hemodialysis catheter-consigned patients. METHODS: Salvage of abandoned vascular access sites was attempted in 16 patients with hemodialysis catheters. These vascular access sites were salvaged using endovascular bypass techniques to redirect the access flow to a nonarterialized vein as a new outflow conduit or cannulation segment...
March 1, 2018: Journal of Vascular Access
Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Philip Gc Chan, Gerard S Goh
PURPOSE: The AngioJet Hemolytic Thrombectomy Device "AngioJet" (Boston Scientific, Malborough, MA, USA) is a rheolytic thrombectomy device that can be used in the treatment of hemodialysis arteriovenous fistula and graft thrombosis. We aim to appraise the current evidence on AngioJet thrombectomy in hemodialysis vascular access thrombosis, and to determine its safety, including complications and efficacy. MATERIALS AND METHODS: An electronic literature search was performed on the MEDLINE and Embase databases...
March 1, 2018: Journal of Vascular Access
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
Ryo Sato, Tetsuhiko Sato, Yuichi Shirasawa, Chika Kondo, Masao Tadakoshi, Michio Fukuda, Nobuyuki Ohte, Kunio Morozumi
OBJECTIVE: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt® ) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty...
March 1, 2018: Journal of Vascular Access
Kenneth Abreo, Adrian Sequeira
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents...
March 1, 2018: Journal of Vascular Access
Hoon Suk Park, Joonsung Choi, Hyung Wook Kim, Jun Hyun Baik, Cheol Whee Park, Young Ok Kim, Chul Woo Yang, Dong Chan Jin
PURPOSE: The exchange from a non-tunneled hemodialysis catheter to a tunneled one over a guidewire using a previous venotomy has been reported to be safe. However, some concerns that it may increase infection risk prevent its clinical application. This approach seems particularly useful for acute kidney injury patients requiring initial renal replacement therapy, in whom we frequently worry about the choice of non-tunneled versus tunneled catheters. MATERIALS AND METHODS: From March 2012 to February 2016, 88 cases to receive the over-the-guidewire exchange method from a non-tunneled to a tunneled catheter and 521 cases to receive de novo tunneled catheter placement from the hemodialysis vascular access cohort were compared retrospectively...
March 1, 2018: Journal of Vascular Access
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
Cindy You, Shishir Sharma, Aakash Bavishi, Christopher A Groh, Yazan Alia, Basil Saour, Rod Passman
BACKGROUND: Hemodialysis (HD) patients have a high risk of sudden death but limited vascular access and high complication rates from transvenous implantable cardioverter-defibrillators (ICDs). Subcutaneous ICDs (S-ICD) may be an alternative, but dynamic ECG changes may result in inappropriate shocks. This study aims to define the screen failure rate for S-ICD in patients pre- and post-HD. METHODS: ECG waveforms were obtained using electrodes mimicking the S-ICD sensing vectors in an unselected test group of chronic HD patients and a control group of ICD-eligible non-dialysis patients...
March 10, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Almudena Vega, Soraya Abad, Inés Aragoncillo, Isabel Galán, Nicolás Macías, Santiago Cedeño, Alba Santos, Ana García, Tania Linares, María Martínez-Villaescusa, Juan M López-Gómez
Introduction It is important to monitor vascular access in patients with stage 5 chronic kidney disease receiving hemodialysis. Access recirculation can help to detect a need for intervention. OBJECTIVES: To compare urea recirculation with recirculation by thermodilution using blood temperature monitoring to predict a need for intervention of vascular access over a 6-month period. METHODS: We analyzed urea recirculation and blood temperature monitoring simultaneously in 61 patients undergoing hemodialysis...
March 1, 2018: Journal of Vascular Access
Chun-Fan Chen, Chih-Ching Lin
Some hemodialysis patients suffer from repeat dysfunction of dialysis vascular access and need procedures of angioplasty, thrombectomy, and even temporary catheter use. Why these patients are vulnerable to vascular access dysfunction and how to improve its patency are imperative to be discovered. Traditional risk factors for vascular access function had been widely investigated but could not fully explain this question. Several genotype polymorphisms were demonstrated to increase the incidence of cardiovascular disease and might also be linked to higher risk of vascular access dysfunction...
February 1, 2018: Journal of Vascular Access
Surendra Shenoy, Michael Allon, Gerald Beathard, Deborah Brouwer-Maier, Laura M Dember, Mark Glickman, Celeste Lee, Terry Litchfield, Charmaine Lok, Thomas Huber, Prabir Roy-Chaudhury, Jack Work, Melissa West, Haimanot Wasse
No abstract text is available yet for this article.
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Andrea K Viecelli, Allison Tong, Emma O'Lone, Angela Ju, Camilla S Hanson, Benedicte Sautenet, Jonathan C Craig, Braden Manns, Martin Howell, Eric Chemla, Lai-Seong Hooi, David W Johnson, Timmy Lee, Charmaine E Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Carmel M Hawley
Vascular access outcomes in hemodialysis are critically important for patients and clinicians, but frequently are neither patient relevant nor measured consistently in randomized trials. A Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop was convened to discuss the development of a core outcome measure for vascular access. 13 patients/caregivers and 46 professionals (clinicians, policy makers, industry representatives, and researchers) attended. Participants advocated for vascular access function to be a core outcome based on the broad applicability of function regardless of access type, involvement of a multidisciplinary team in achieving a functioning access, and the impact of access function on quality of life, survival, and other access-related outcomes...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Federico Nalesso, Francesco Garzotto, Ilaria Petrucci, Sara Samoni, Grazia Maria Virzì, Dario Gregori, Mario Meola, Claudio Ronco
INTRODUCTION: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. MATERIALS AND METHODS: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up...
January 26, 2018: Blood Purification
Kelsey Gray, Abraham Korn, Joshua Zane, Gabriel Conzalez, Amy Kaji, Nina Bowens, Christian de Virgilio
INTRODUCTION: Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended prior to 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 that 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...
February 22, 2018: Annals of Vascular Surgery
Kelsey Gray, Abraham Korn, Joshua Zane, Hamid Alipour, Amy Kaji, Nina Bowens, Christian de Virgilio
INTRODUCTION: 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...
February 22, 2018: Annals of Vascular Surgery
Tushar J Vachharajani, Anil K Agarwal, Arif Asif
Exhausted vasculature is not uncommon in patients receiving long-term hemodialysis treatment. Certain patients exhaust their peripheral veins and do not retain the venous capital necessary for fistula creation. Others suffer from severe peripheral arterial disease and despite the presence of adequate venous capital are not able to receive an arteriovenous access successfully. Most importantly, in the case of occluded central veins, the creation of an arteriovenous access in the arms or thighs would be futile, even if peripheral veins and/or arteries were available...
February 21, 2018: Kidney International
Hyunwoo Kim, Hye Mi Seo, Ji Young Kim, Miyeon Kim
PURPOSE: Segmental bioimpedance analysis (BIA) can identify fluid volume changes in the arms of patients on hemodialysis (HD) after vascular access surgery. We investigated whether the difference in fluid volumes between the arms of the patients using segmental BIA is associated with vascular access outcome. METHODS: Body composition measurements were taken for 127 patients on HD with segmental, multi-frequency BIA equipment (InBody 1.0, Biospace Co. Ltd, Seoul, Korea)...
February 23, 2018: International Urology and Nephrology
Juliana Jaramillo, Karen T Valencia-Rivero, Francisco J Cedano-Serrano, Rocío López, Néstor Sandoval, Juan C Briceño
Synthetic vascular access for hemodialysis exhibits biological and mechanical material properties mismatch with the native vessels. These limitations prevent infiltration of endothelial cells and decrease grafts long-term patency, particularly in small diameter vessels. We aimed to design a curved structural reinforced small intestinal submucosa (SIS) vascular graft for hemodialysis access and to evaluate in a porcine animal model graft patency by Doppler ultrasonography, tissue remodeling by histology, and vascular wall Young's modulus after implantation by biaxial tensile test...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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