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Hero graft

Miltos K Lazarides, Christos Argyriou, Andreas Koutsoumpelis, Efstratios I Georgakarakos, George S Georgiadis
Thigh arteriovenous grafts are required in a number of patients with exhausted upper extremity veins and comprise 1%-5% of the total access procedures performed. Alternative autogenous lower extremity options are the rarely used sapheno-tibial arteriovenous fistulae, the saphenous vein transpositions, and the femoral vein transpositions. The latter have proven to be the most durable lower limb access procedures, with low infection rates and their primary patency rates ranged from 74% up to 87% at 2 years...
March 1, 2018: Journal of Vascular Access
John W Perry, David Hardy, Shvetank Agarwal, Gautam Agarwal
Hemodialysis Reliable Outflow (HeRO) grafts (Merit Medical Systems, Inc, South Jordan, Utah) provide a means for access in catheter-dependent hemodialysis patients but typically require several weeks for tissue incorporation. Modifying the HeRO graft with an ACUSEAL graft (W. L. Gore & Associates, Newark, Del) can allow immediate cannulation, thus reducing catheter dependence time and its associated complications. A retrospective review of patients at our institution from 2013 to 2016 who underwent placement of a modified HeRO dialysis system with ACUSEAL graft was performed...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Sneha Somani, Hamed Jalaeian, Ty B Dunn, Prashant Shrestha
No abstract text is available yet for this article.
November 13, 2017: Journal of Vascular Access
Andrew S Griffin, Shawn M Gage, Jeffrey H Lawson, Charles Y Kim
OBJECTIVE: This study evaluated whether the use of a staged Hemodialysis Reliable Outflow (HeRO; Merit Medical, South Jordan, Utah) implantation strategy incurs increased early infection risk compared with conventional primary HeRO implantation. METHODS: A retrospective review was performed of 192 hemodialysis patients who underwent HeRO graft implantation: 105 patients underwent primary HeRO implantation in the operating room, and 87 underwent a staged implantation where a previously inserted tunneled central venous catheter was used for guidewire access for the venous outflow component...
January 2017: Journal of Vascular Surgery
Dr Charlotte Ratcliff, Miss Monica Hansrani
INTRODUCTION: This case report intends to highlight the Haemodialysis Reliable Outflow (HeRO) graft as a potential long term option for ongoing dialysis in patients with central venous stenosis. PRESENTATION OF CASE: A 55year old patient, who developed end stage renal failure (ESRF) after chemotherapy treatment for breast cancer, presented at the limit of her dialysis access after a 15year haemodialysis history causing central vein stenosis. The patient was initially started on peritoneal dialysis but after repeated peritonitis was switched to haemodialysis...
2016: International Journal of Surgery Case Reports
Evan R Brownie, Clark D Kensinger, Irene D Feurer, Derek E Moore, David Shaffer
OBJECTIVE: With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts...
November 2016: Journal of Vascular Surgery
Samer A Naffouje, Ivo Tzvetanov, James T Bui, Ron Gaba, Karrel Bernardo, Hoonbae Jeon
BACKGROUND: Hemodialysis reliable outflow (HeRO) catheters were introduced in 2008, and have been since providing a reliable alternative for hemodialysis patients who are deemed "access challenged." However, its outcomes have not been extensively investigated due to its relatively young age. Here, we report our 6-year single institution experience, and demonstrate the significant impact of obesity on HeRO graft outcomes, an aspect not previously studied in the literature. METHODS: Patients who underwent HeRO graft placement at the University of Illinois Hospital between April 2009 and August 2015 were included retrospectively...
October 2016: Annals of Vascular Surgery
Marc H Glickman
BACKGROUND: The role of the HeRO graft in central venous pathology has been defined in the literature and clinically. There have been two publications or abstracts that have compared the patency rates and outcomes of this graft to the lower extremity graft. AIM: The outcomes of both publications leads to an algorithm suggested by the author in determining which procedure should be used for specific patients. METHODS: Both papers trend to show that lower extremity grafts have improved patency rates when compared to the HeRO device in the upper extremity...
March 2016: Journal of Vascular Access
Kathryn L Davis, John C Gurley, Daniel L Davenport, Eleftherios S Xenos
OBJECTIVES: Hemodialysis (HD) patients with superior vena cava (SVC) occlusion have limited access options. Femoral access is commonly employed but is associated with high complication rates. Hemodialysis Reliable Outflow (HeRO) catheters can be used in tunneled catheter-dependent (TCD) patients who have exhausted other access options. The HeRO graft bypasses occlusion and traverses stenosis with outflow directly into the central venous circulation. At our institution we have used the inside-out central venous access technique (IOCVA) to traverse an occluded vena cava for HeRO graft placement...
March 2016: Journal of Vascular Access
Robert Provenzano, Paula LaFleur, Lori McFadden, Matthew LaFleur, David Lorelli
The Hemodialysis Reliable Outflow (HeRO) graft was compared to the cuffed catheter in end-stage renal disease patients. All consented patients were evaluated for HeRO graft placement. Eligible patients that did not receive a graft were enrolled in the control group. Participants who had not exhausted peripheral venous access sites suitable for fistulas and grafts were excluded. Differences in quality of life and incidence of bacteremia, vascular interventions, hospitalizations, and death were evaluated over one year...
November 2015: Nephrology News & Issues
Wojciech Błachucki, Jakub Szlachetko, Yves Kayser, Jean-Claude Dousse, Joanna Hoszowska, Daniel L A Fernandes, Jacinto Sá
We report on the reactivity of grafted tantalum organometallic catalysts with molecular oxygen. The changes in the local Ta electronic structure were followed by in situ high-energy resolution off-resonant spectroscopy (HEROS). The results revealed agglomeration and formation of Ta dimers, which cannot be reversed. The process occurs independently of starting grafted complex.
July 28, 2015: Physical Chemistry Chemical Physics: PCCP
J Al Shakarchi, J G Houston, R G Jones, N Inston
OBJECTIVES: With improved dialysis survival there are increasing numbers of patients who have exhausted definitive access options due to central venous stenosis and are maintaining dialysis on a central venous catheter. The Hemodialysis Reliable Outflow (HeRO) allows an alternative by providing a definitive access solution. The aim of this study is to systematically review the published outcomes of the HeRO graft and discuss the role in complex haemodialysis patients. METHODS: Electronic databases were searched for studies assessing the use of the HeRO graft for dialysis in accordance with PRISMA published up to December 31 2014...
July 2015: European Journal of Vascular and Endovascular Surgery
Clark Kensinger, Evan Brownie, Peter Bream, Derek Moore
BACKGROUND: The hemodialysis reliable outflow (HeRO) access device is a permanent dialysis graft used in patients with central venous obstruction. Given the complexity of care related to end-stage dialysis access (ESDA) patients, a multidisciplinary approach has been used to achieve operative success of HeRO graft placement. METHODS: The single-center retrospective review included adult patients that were seen in ESDA clinic who underwent a HeRO graft placement from September 2010-September 2014 under the care of a team consisting of a nephrologist, an interventional radiologist, and a surgeon...
November 2015: Journal of Surgical Research
Esther M van Wezel, Janine Stutterheim, Florentien Vree, Lily Zappeij-Kannegieter, Boris Decarolis, Barbara Hero, Frank Berthold, Roswitha Schumacher-Kuckelkorn, Thorsten Simon, Marta Fiocco, Carlijn Voermans, Max M van Noesel, Huib N Caron, C Ellen van der Schoot, Godelieve A M Tytgat
BACKGROUND: The clinical significance of minimal residual disease (MRD) detected by real-time quantitative PCR (qPCR) in autologous stem cell grafts in high risk neuroblastoma is still controversial. In this retrospective multicenter study, autologous stem cell grafts of a large cohort were studied using a panel of RNA markers. PROCEDURE: From 104 patients with high risk neuroblastoma, who received autologous stem cell transplantation as first line treatment, 66 peripheral blood stem cells (PBSC) and 38 CD34+ selected grafts were retrospectively collected at 2 Dutch and 12 German centers between 1997 and 2010...
August 2015: Pediatric Blood & Cancer
Steven Nicholas Graves, Deana Saleh Shenaq, Alexander J Langerman, David H Song
BACKGROUND: Significant improvements can be made in recoding surgical procedures, particularly in capturing high-quality video recordings from the surgeons' point of view. This study examined the utility of the GoPro HERO 3+ Black Edition camera for high-definition, point-of-view recordings of plastic and reconstructive surgery. METHODS: The GoPro HERO 3+ Black Edition camera was head-mounted on the surgeon and oriented to the surgeon's perspective using the GoPro App...
February 2015: Plastic and Reconstructive Surgery. Global Open
William J Yoon, David R Lorelli
PURPOSE: To evaluate a two-stage Hemodialysis Reliable Outflow (HeRO) implantation technique that avoids the use of a femoral bridging catheter versus the conventional one-stage technique requiring a bridging catheter in selected patients. METHODS: A retrospective review was performed on 20 end-stage renal disease patients with an internal jugular vein (IJV) catheter selected for two-stage HeRO implantation at our institution between January 2010 and March 2013...
May 2015: Journal of Vascular Access
William J Yoon, David R Lorelli
PURPOSE: The purpose of this study is to report a novel two-stage Hemodialysis Reliable Outflow (HeRO) graft implantation technique that avoids the use of a femoral bridging hemodialysis catheter in internal jugular vein (IJV) catheter-dependent patients with contralateral central venous occlusion. METHODS: The first stage is to implant the ePTFE component and consists of: 1) performing two to three incisions in the upper arm ipsilateral to the preexisting IJV catheter, 2) tunneling the expanded polytetrafluoroethylene (ePTFE) component through these incision sites, and 3) placing the ePTFE component in the subcutaneous tissue without anastomosing it to the target artery...
January 2015: Journal of Vascular Access
Daniel J Torrent, Mandy R Maness, Swapnil D Kachare, Jill N Zink, Carl E Haisch, Robert C Harland, Claire Morgan, Rodney L Guyton, Avery G Colomb, David W Barham, Eric C Katz, Michael C Stoner
BACKGROUND: The Hemodialysis Reliable Outflow (HeRO) vascular access device is a hybrid polytetrafluoroethylene graft-stent construct designed to address central venous occlusive disease. Although initial experience has demonstrated excellent mid-term patency rates, subsequent studies have led to external validity questions. The purpose of this study was to examine a single center experience with this vascular access device in challenging access cases with associated costs. METHODS: A retrospective study representing the authors' cumulative HeRO vascular access device experience was undertaken...
November 2014: Journal of Surgical Research
Peter S Amenta, Roberto C Heros
No abstract text is available yet for this article.
February 2015: World Neurosurgery
Elizabeth A Kudlaty, Jeanne Pan, Matthew T Allemang, Daniel E Kendrick, Vikram S Kashyap, Virginia L Wong
BACKGROUND: Maintaining and establishing vascular access in end-stage renal disease (ESRD) patients is complicated when they are poor candidates for traditional upper extremity access. Our objective was to compare our experience with 2 alternative dialysis accesses, the femoral arteriovenous graft (fAVG) and the Hemodialysis Reliable Outflow (HeRO), in patients with limited remaining options. METHODS: A single institution, retrospective review of ESRD patients with fAVG or HeRO placed between May 2009 and February 2013 was performed...
January 2015: Annals of Vascular Surgery
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