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Registry vascular access

Steven G Schauer, Michael D April, Guyon J Hill, Jason F Naylor, Matthew A Borgman, Robert A De Lorenzo
BACKGROUND: United States (US) and coalition military medical units deployed to combat zones frequently encounter pediatric trauma patients. Pediatric patients may present unique challenges due to their anatomical and physiological characteristics and most military prehospital providers lack pediatric-specific training. A minimal amount of data exists to illuminate the prehospital care of pediatric patients in this environment. We describe the prehospital care of pediatric trauma patients in Iraq and Afghanistan...
March 1, 2018: Prehospital Emergency Care
Angela L Chiew, Christian Gluud, Jesper Brok, Nick A Buckley
BACKGROUND: Paracetamol (acetaminophen) is the most widely used non-prescription analgesic in the world. Paracetamol is commonly taken in overdose either deliberately or unintentionally. In high-income countries, paracetamol toxicity is a common cause of acute liver injury. There are various interventions to treat paracetamol poisoning, depending on the clinical status of the person. These interventions include inhibiting the absorption of paracetamol from the gastrointestinal tract (decontamination), removal of paracetamol from the vascular system, and antidotes to prevent the formation of, or to detoxify, metabolites...
February 23, 2018: Cochrane Database of Systematic Reviews
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
Marwan Badri, Timothy Shapiro, Yongfei Wang, Karl E Minges, Jeptha P Curtis, William A Gray
OBJECTIVES: This study was designed to examine the association between adopting the transradial approach for percutaneous coronary intervention (PCI) and rates of vascular complications following transfemoral PCI. BACKGROUND: Recent studies raised concerns that operators adopting the transradial approach may lose their transfemoral access skills and experience increased rates of vascular complications. METHODS: Retrospective analysis of data from the NCDR CathPCI Registry to examine the rates of vascular complications among physicians who were femoral operators (>90% of cases) in 2010-2011 and later adopted the transradial approach to PCI among low-, intermediate-, or high-level adopters (≤33%, 34-66%, and >66%, respectively) in 2014-2015...
January 23, 2018: Catheterization and Cardiovascular Interventions
Marek Kowalski, Cornelia Deutsch, Steffen Hofmann, Norbert Franz, Michael Billion, Abbas Ferdosi, Peter Bramlage, Guram Imnadze, Henning Warnecke
Introduction: The "transfemoral (TF) first" approach to access route selection in transcatheter aortic valve implantation (TAVI) is popular; however, the risk of major vascular complications is substantial. The "best for TF" approach identifies only the patients with ideal anatomy for TF-TAVI, potentially minimizing complications. Aim: To characterize the outcomes of patients undergoing TAVI at a large-volume site that employs this approach. Material and methods: Patients who underwent TAVI at the Bad Rothenfelde Heart Centre between 2008 and 2016 were consecutively enrolled...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ open quality
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
Andrew M Goldsweig, Kevin F Kennedy, Dhaval Kolte, J Dawn Abbott, Paul C Gordon, Barry L Sharaf, Frank W Sellke, Afshin Ehsan, Neel R Sodha, Frank Rutar, Herbert D Aronow
BACKGROUND: Transcatheter aortic valve replacement (TAVR) exposes patients to radiation. OBJECTIVES: We sought to identify factors associated with higher radiation exposure and to quantify their relative influence, which may inform reduction of this hazard. METHODS: All TAVR procedures at Rhode Island Hospital between March 20, 2012 and February 12, 2017 were included. Procedures were performed by two co-primary operators using a Siemens Artis Zeego system...
December 27, 2017: Catheterization and Cardiovascular Interventions
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
December 1, 2017: Journal of Endovascular Therapy
Masahiro Yamawaki, Motoharu Araki, Tsutomu Ito, Yosuke Honda, Takahiro Tokuda, Yoshiaki Ito, Hiroshi Ueno, Kazuki Mizutani, Minoru Tabata, Akihiro Higashimori, Norio Tada, Kensuke Takagi, Futoshi Yamanaka, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Shinichi Shirai, Kentaro Hayashida
Peripheral artery disease plays a pivotal role for access site selection in transcatheter aortic valve replacement (TAVR). Abnormal ankle-brachial index (ABI) is a generalized mortality marker in many cardiovascular scenarios. However, the long-term outcomes in high-risk TAVR populations remain unclear. We investigated the association between low ABI and 2-year outcome after TAVR. Of 1613 patients enrolled in the OCEAN-TAVI registry, 1458 (90.4%) who underwent ABI before TAVR were divided into groups: patients with (1) ABI ≥ 0...
December 11, 2017: Heart and Vessels
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
Janusz Kochman, Łukasz Kołtowski, Zenon Huczek, Bartosz Rymuza, Radosław Wilimski, Maciej Dąbrowski, Adam Witkowski, Marek Grygier, Anna Olasińska-Wiśniewska, Piotr Kubler, Krzysztof Reczuch, Radosław Parma, Andrzej Ochała, Dariusz Jagielak, Wacław Kochman, Eberhard Grube
BACKGROUND: Although the femoral approach is the most common route utilized in transcatheter aortic valve implantation (TAVI) it still carries a substantial risk of severe bleeding and vascular complications. The aim of our study was to compare the safety and efficacy of the complete percutaneous (CPC) approach with surgical cutdown and closure (SCC) in TAVI patients. METHODS: The study population comprised 683 patients with severe aortic stenosis who underwent transfemoral TAVI...
November 13, 2017: Kardiologia Polska
Rafał Januszek, Zbigniew Siudak, Artur Dziewierz, Dariusz Dudek, Stanisław Bartuś
OBJECTIVE: The aim of the study was to assess trends in the use and periprocedural outcomes of rotational atherectomy (RA) in Poland between January 2014 and December 2016. BACKGROUND: In recent years, due to the aging population, RA is becoming more commonly used to treat heavily calcified coronary artery stenoses. METHODS: Data were prospectively collected using the Polish Cardiovascular Intervention Society national registry on all percutaneous coronary intervention (PCI) procedures performed in Poland...
October 25, 2017: Catheterization and Cardiovascular Interventions
Marco Barbanti, Jan Baan, Mark S Spence, Fortunato Iacovelli, Gian Luca Martinelli, Francesco Saia, Alessandro Santo Bortone, Frank van der Kley, Douglas F Muir, Cameron G Densem, Marije Vis, Martijn S van Mourik, Lenka Seilerova, Claudia M Lüske, Peter Bramlage, Corrado Tamburino
BACKGROUND: There is an increasing trend towards shorter hospital stays after transcatheter aortic valve implantation (TAVI), in particular for patients undergoing the procedure via transfemoral (TF) access. Preliminary data suggest that there exists a population of patients that can be discharged safely very early after TF-TAVI. However, current evidence is limited to few retrospective studies, encompassing relatively small sample sizes. METHODS: The Feasibility And Safety of early discharge after Transfemoral TAVI (FAST-TAVI) registry is a prospective observational registry that will be conducted at 10 sites across Italy, the Netherlands and the UK...
October 10, 2017: BMC Cardiovascular Disorders
Arno Téblick, Wies Vanderbruggen, Tom Vandendriessche, Johan Bosmans, Steven Els Frans Haine, Hielko Miljoen, Vincent Segers, Kristien Wouters, Christiaan Vrints, Marc J Claeys
BACKGROUND: Radial access (RA) and vascular closure devices (VCD) have been shown to be superior to transfemoral access (TFA) with regard to the prevention of vascular complications after percutaneous coronary intervention (PCI). OBJECTIVE: The present study evaluates whether RA is associated with less vascular complications and a lower mortality than VCD. METHODS: A total of 6999 consecutive PCI patients were studied through a single-centre prospective registry from January 2011 to August 2015...
August 29, 2017: Acta Cardiologica
John D Carroll, Sreekanth Vemulapalli, Dadi Dai, Roland Matsouaka, Eugene Blackstone, Fred Edwards, Frederick A Masoudi, Michael Mack, Eric D Peterson, David Holmes, John S Rumsfeld, E Murat Tuzcu, Frederick Grover
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been introduced into U.S. clinical practice with efforts to optimize outcomes and minimize the learning curve. OBJECTIVES: The goal of this study was to assess the degree to which increasing experience during the introduction of this procedure, separated from other outcome determinants including patient and procedural characteristics, is associated with outcomes. METHODS: The authors evaluated the association of hospital TAVR volume and patient outcomes for TAVR by using data from 42,988 commercial procedures conducted at 395 hospitals submitting to the Transcatheter Valve Therapy Registry from 2011 through 2015...
July 4, 2017: Journal of the American College of Cardiology
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
Mauro Romano, Derk Frank, Riccardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Cornelia Deutsch, Peter Bramlage, Martin Thoenes, Vinayak Bapat
OBJECTIVES: Transaortic (TAo) access for transcatheter aortic valve implantation (TAVI) is an alternative to the conventional transfemoral or transapical routes. Data comparing the characteristics and outcomes of TAo-TAVI using the SAPIEN XT and SAPIEN 3 heart valves are scarce. The objective of the current analysis was to provide such information. METHODS: ROUTE is an international, prospective, observational registry. Patients with severe calcific aortic stenosis scheduled for TAo-TAVI with an Edwards SAPIEN XT or a SAPIEN 3 heart valve were consecutively enrolled at 22 centres across Europe between February 2013 and February 2015...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
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