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Vascular access trends

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https://www.readbyqxmd.com/read/28430318/teaching-medical-students-ultrasound-guided-vascular-access-which-learning-method-is-best
#1
Alwin Lian, James C R Rippey, Peter J Carr
INTRODUCTION: Ultrasound is recommended to guide insertion of peripheral intravenous vascular cannulae (PIVC) where difficulty is experienced. Ultrasound machines are now common-place and junior doctors are often expected to be able to use them. The educational standards for this skill are highly varied, ranging from no education, to self-guided internet-based education, to formal, face-to-face traditional education. In an attempt to decide which educational technique our institution should introduce, a small pilot trial comparing educational techniques was designed...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28385401/vascular-access-site-and-outcomes-among-26-807-chronic-total-coronary-occlusion-angioplasty-cases-from-the-british-cardiovascular-interventions-society-national-database
#2
Tim Kinnaird, Richard Anderson, Nick Ossei-Gerning, Sean Gallagher, Adrian Large, Julian Strange, Peter Ludman, Mark de Belder, James Nolan, David Hildick-Smith, Mamas Mamas
OBJECTIVES: The aim of this study was to assess, using a national percutaneous coronary intervention (PCI) database, access-site choice and outcomes after chronic total occlusion (CTO) PCI. BACKGROUND: Given the influence of access site on outcomes, the use of radial access in CTO PCI warrants further investigation. METHODS: Data were analyzed from the British Cardiovascular Intervention Society dataset of 26,807 elective CTO PCI procedures performed in England and Wales between 2006 and 2013...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296143/targeting-the-safe-zone
#3
Andrea Mignatti, Patricia Friedmann, David Paul Slovut
OBJECTIVE: The aim of this study was to assess the effectiveness of a quality improvement (QI) program in reducing vascular complications during cardiac catheterization. BACKGROUND: Vascular access complications during cardiac catheterization are associated with higher morbidity and mortality. We implemented a QI program focused on using micropuncture techniques and targeting the "safe zone," an area below the inferior border of the inferior epigastric artery and above the inferior border of the femoral head, for femoral artery puncture...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28261745/ultrasound-examination-with-color-power-doppler-to-assess-the-early-response-of-apical-periodontitis-to-the-endodontic-treatment
#4
Elisabetta Cotti, Stefano Andrea Esposito, Davide Musu, Girolamo Campisi, Hagay Shemesh
OBJECTIVES: The purpose of this study was to assess the possibility to detect early vascular changes in apical periodontitis (AP) using ultrasound examination with color power Doppler (US-CPD) and to establish a correlation between the early response of AP to treatment and its potential healing. MATERIALS AND METHODS: Twenty-one apical lesions were visualized with US-CPD before endodontic treatment, 1 week after the first access to endodontic system and 4 weeks after root canal obturation...
March 6, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#5
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28127726/improving-outcomes-of-short-peripheral-vascular-access-in-oncology-and-chemotherapy-administration
#6
Sergio Bertoglio, Ton van Boxtel, Godelieve A Goossens, Lisa Dougherty, Rhoikos Furtwangler, Elaine Lennan, Mauro Pittiruti, Katarina Sjovall, Marguerite Stas
A short peripheral intravenous catheter or cannula (PIVC) is frequently used to deliver chemotherapy in oncology practice. Although safe and easy to insert, PIVCs do fail, leading to personal discomfort for patients and adding substantially to treatment costs. As the procedure of peripheral catheterization is invasive, there is a need for greater consistency in the choice, insertion and management of short PIVCs, particularly in the oncology setting where there is a growing trend for patients to receive many different courses of IV treatment over a number of years, sometimes with only short remissions...
January 25, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#7
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28027805/variations-in-outcomes-of-hemodialysis-vascular-access-by-race-ethnicity-in-the-elderly
#8
Karen Woo, Laura Gascue, Dana P Goldman, John A Romley
OBJECTIVE: Prevalence of end-stage renal disease, modality of treatment, and type of hemodialysis vascular access used varies widely by race/ethnicity in the United States, but outcomes of hemodialysis vascular access by race/ethnicity are poorly described. The objective of this study is to evaluate variations in outcomes of hemodialysis vascular access in the elderly by race/ethnicity. METHODS: Medicare outpatient, inpatient, and carrier files were queried from 2006 to 2011 for beneficiaries that were age ≥66 years and dialysis-dependent at time of index fistula/graft creation, qualified for Medicare by age only, and were continuously enrolled in Medicare 12 months before and after index fistula/graft creation...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28007135/sex-based-differences-in-outcomes-with-transcatheter-aortic-valve-therapy-tvt-registry-from-2011-to-2014
#9
Jaya Chandrasekhar, George Dangas, Jennifer Yu, Sreekanth Vemulapalli, Sunil Suchindran, Amit N Vora, Usman Baber, Roxana Mehran
BACKGROUND: A differential impact of sex has been observed in transcatheter aortic valve replacement (TAVR) outcomes from small observational studies and subgroup analyses of randomized trials. OBJECTIVES: The goal of this study was to compare the in-hospital and 1-year outcomes in male and female subjects from the U.S. nationwide TAVR registry. METHODS: National data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry were used for in-hospital outcomes, and data linked from the Centers for Medicare & Medicaid Services were used to provide 1-year events...
December 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27982377/polypharmacy-and-polymorbidity-in-older-adults-in-brazil-a-public-health-challenge
#10
Luiz Roberto Ramos, Noemia Urruth Leão Tavares, Andréa Dâmaso Bertoldi, Mareni Rocha Farias, Maria Auxiliadora Oliveira, Vera Lucia Luiza, Tatiane da Silva Dal Pizzol, Paulo Sérgio Dourado Arrais, Sotero Serrate Mengue
OBJECTIVE: To analyze variations in the prevalence of chronic use of medicines by older adults in Brazil according to its possible association with the most prevalent chronic diseases and demographic and health factors, and to identify risk factors for polypharmacy. METHODS: A study based on data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), a cross-sectional, population-based survey with probability sampling in Brazilian urban areas...
December 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/27951576/future-trends-in-vascular-access-creation
#11
Surendra Shenoy
Delivery of a prescribed dialysis dose, which is critical for longevity on hemodialysis, is directly dependent on vascular access (VA). However, VA is fraught with high failure rates and has room for innovation. Arteriovenous fistula (AVF), considered the 'best choice', has a high 'failure to mature' rate. Arteriovenous grafts (AVGs) are considered when patients are poor candidates for or have failed AVF, but have a high incidence of infections and thrombosis. Due to associated morbidity and mortality from complications, central venous catheters are considered only as 'bridging short-term access' when there is an urgent need for dialysis...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27932929/a-systematic-florula-of-a-disturbed-urban-habitat-pavements-of-sheffield-england
#12
Oliver L Pescott
BACKGROUND: Human settlements are of increasing interest to ecologists, a fact demonstrated by the recent cluster of book-length treatments of the topic (Forman 2008, McDonnell et al. 2009, Gaston 2010, Niemelä et al. 2011, Wilson 2011, Forman 2014). The natural world as a fascinating feature of towns and cities has a much longer history (e.g. Fitter 1945), and has also played a strong part in local biological conservation in some countries over the late 20th Century (Goode 2014​)...
2016: Biodiversity Data Journal
https://www.readbyqxmd.com/read/27907893/factors-impacting-complication-rates-for-catheter-ablation-of-atrial-fibrillation-from-2003-to-2015
#13
Eunice Yang, Esra Gucuk Ipek, Muhammad Balouch, Yuliya Mints, Jonathan Chrispin, Joseph E Marine, Ronald D Berger, Hiroshi Ashikaga, Jack Rickard, Hugh Calkins, Saman Nazarian, David D Spragg
AIMS: Complications from catheter ablation for atrial fibrillation (AF) are well described. Changing aspects of AF ablation including patient populations referred, institutional experience, and emerging catheter and pharmacological options may impact complication rates. We assessed procedural complication trends in AF ablation patients from 2003-2015 to identify what factors affect adverse event rates. METHODS AND RESULTS: We evaluated consecutively enrolled patients undergoing initial AF ablation from 2003 through 2015...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27892915/patient-access-improving-wait-times-in-a-specialty-clinic
#14
Tarina Kwong
A vascular surgery clinic in an academic center faced many delays for patients in gaining access to an appointment. In January 2014, wait times from referral to patient appointment were estimated to be 3 to 4 weeks. A 6-month pilot project was conducted from January 2014 through June 2014 with the aim of scheduling 50% of new patients within 7 days of referral. The clinic manager, medical director, clinic staff, and clerical team worked in partnership to initiate a series of interventions to reduce the backlog of patients, implement scheduling guidelines, and use nurse practitioners to improve practice efficiencies...
January 2016: Health Care Manager
https://www.readbyqxmd.com/read/27876066/in-vivo-cardiovascular-magnetic-resonance-of-2d-vessel-wall-diffusion-anisotropy-in-carotid-arteries
#15
Peter Opriessnig, Harald Mangge, Rudolf Stollberger, Hannes Deutschmann, Gernot Reishofer
BACKGROUND: Diffusion weighted (DW) cardiovascular magnetic resonance (CMR) has shown great potential to discriminate between healthy and diseased vessel tissue by evaluating the apparent diffusion coefficient (ADC) along the arterial axis. Recently, ex vivo studies on porcine arteries utilizing diffusion tensor imaging (DTI) revealed a circumferential fiber orientation rather than an organization in axial direction, suggesting dominant diffusion perpendicular to the slice direction. In the present study, we propose a method to access tangential and radial diffusion of carotids in vivo by utilizing a pulse sequence that enables high resolution DW imaging in combination with a two-dimensional (2D) diffusion gradient direction sampling scheme perpendicular to the longitudinal axis of the artery...
November 23, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27845956/the-association-of-night-time-systolic-blood-pressure-with-ultrasound-markers-of-subclinical-cardiac-and-vascular-disease
#16
RANDOMIZED CONTROLLED TRIAL
Anne Marie O'Flynn, Emily Ho, Eamon Dolan, Ronan J Curtin, Patricia M Kearney
INTRODUCTION: The aim of this study was to examine the association of night-time systolic blood pressure (BP) with subclinical cardiac dysfunction measured by global longitudinal strain (GLS) and subclinical vascular damage measured by carotid intima-media thickness (CIMT) and carotid plaques. METHODS: GLS was measured by speckle-tracking analysis of echocardiogram images. CIMT was measured at the distal 1 cm of the common carotid artery. The presence of carotid plaques was recorded...
February 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/27765306/neurological-outcomes-with-embolic-protection-devices-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis-of-randomized%C3%A2-controlled-trials
#17
Gennaro Giustino, Roxana Mehran, Roland Veltkamp, Michela Faggioni, Usman Baber, George D Dangas
OBJECTIVES: The aim of this study was to investigate the efficacy and safety of intraprocedural embolic protection (EP) during transcatheter aortic valve replacement (TAVR). BACKGROUND: Randomized controlled trials (RCTs) investigating the efficacy of EP devices during TAVR were relatively underpowered. METHODS: A systematic review and study-level meta-analysis was performed of randomized controlled trials that tested the efficacy and safety of EP during TAVR...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27763477/temporal-variability-of-readmission-determinants-in-postoperative-vascular-surgery-patients
#18
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27723253/a-comprehensive-renal-vascular-access-clinic-results-in-improved-patient-outcomes-and-reduced-costs
#19
Shannon D Thomas, Eugenia C Ip, Nedal Katib, Debbie Pugh, Andrew Lennox, Zoltan Endre, Elaine Tan, Chris Ellery, Ramon L Varcoe
BACKGROUND: Management of vascular access for haemodialysis is a leading cause of morbidity and hospitalization in patients with end-stage renal disease. We sought to evaluate the change in admission and procedural outcomes before and after the establishment of a vascular surgeon-led comprehensive renal vascular access clinic (RVAC). METHOD: A retrospective clinical study was conducted after an RVAC was established in January 2013, with retrospective database created for the 24-month period prior to and after...
October 9, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27701369/trans-axillary-versus-trans-aortic-approach-for-transcatheter-aortic-valve-implantation-with-corevalve-revalving-system-insights-from-multicentre-experience
#20
Claudia Fiorina, Giuseppe Bruschi, Luca Testa, Marco De Carlo, Federico De Marco, Giuseppe Coletti, Stefano Bonardelli, Marianna Adamo, Salvatore Curello, Giovanni Scioti, Paolo Panisi, Francesco Bedogni, Anna S Petronio, Federica Ettori
BACKGROUND: About one-third of candidates for transcatheter aortic valve implantation (TAVI) suffer from severe peripheral artery disease, making the routine femoral approach difficult or impossible. Aim was to compare the trans-axillary (TAx) and the trans-aortic (TAo) route for TAVI with Medtronic CoreValve Revalving System (CRS). METHODS: 242 (23%) out of 1049 consecutive TAVI with 18F CRS were treated in 4 high-volume Italian Centre through TAx (61%) and TAo (39%)...
October 4, 2016: Journal of Cardiovascular Surgery
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