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Vascular access trends

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https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#1
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781949/optn-vascularized-composite-allograft-vca-waiting-list-current-status-and-trends-in-the-united-states
#2
Jennifer L Wainright, Christopher L Wholley, Wida S Cherikh, Jennifer M Musick, David K Klassen
BACKGROUND: Vascularized Composite Allograft (VCA) transplantation is a developing area in the field of transplantation. METHODS: This study used Organ Procurement and Transplantation Network (OPTN) VCA waiting list and transplant data from July 3, 2014 through February 28, 2018 to characterize the OPTN VCA waiting list in terms of composition, removal patterns, waiting time, resulting transplants, and trends over time. RESULTS: Between implementation of the OPTN VCA waiting list on July 3, 2014 and February 28, 2018, 54 candidates - 53...
April 30, 2018: Transplantation
https://www.readbyqxmd.com/read/29668211/a-payer-provider-partnership-for-integrated-care-of-patients-receiving-dialysis
#3
Justin Kindy, David Roer, Robert Wanovich, Stephen McMurray
OBJECTIVES: Patients with end-stage renal disease (ESRD) are clinically complex, requiring intensive and costly care. Coordinated care may improve outcomes and reduce costs. The objective of this study was to determine the impact of a payer-provider care partnership on key clinical and economic outcomes in enrolled patients with ESRD. STUDY DESIGN:  Retrospective observational study. METHODS: Data on patient demographics and clinical outcomes were abstracted from the electronic health records of the dialysis provider...
April 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29615354/improved-access-to-health-care-in-massachusetts-after-2006-massachusetts-healthcare-reform-law-is-associated-with-a-significant-decrease-in-mortality-among-vascular-surgery-patients
#4
Mohammad H Eslami, Katherine Moll Reitz, Denis V Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: Access to medical care, by adequate insurance coverage, has a direct impact on outcomes for patients undergoing vascular procedures. We evaluated in-hospital mortality for patients undergoing index vascular procedures before and after the Massachusetts Healthcare Reform Law (MHRL) in 2006, which mandated insurance for all Massachusetts residents, both in Massachusetts and throughout the United States. METHODS: The National Inpatient Sample was queried to identify patients undergoing interventions for peripheral arterial disease, carotid artery stenosis, and abdominal aortic aneurysms based on International Classification of Diseases, Ninth Revision, Clinical Modification procedural and diagnostic codes...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29572627/functional-impairment-and-risk-of-mortality-in-patients-on-chronic-hemodialysis-results-of-the-lazio-dialysis-registry
#5
Maurizio Bossola, Claudia Marino, Anteo Di Napoli, Nera Agabiti, Luigi Tazza, Marina Davoli
BACKGROUND: Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of this study was to evaluate if functional impairment represents a risk factor for reduced survival in patients on chronic hemodialysis. METHODS: All incident chronic hemodialysis patients of Lazio, a large region of central Italy, registered in the Dialysis and Transplant Lazio Region Registry (DTLRR) in the period 2008-2013 were considered eligible...
March 23, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29478273/temporal-trends-of-in-hospital-complications-associated-with-catheter-ablation-of-atrial-fibrillation-in-the-united-states-an-update-from-nationwide-inpatient-sample-database-2011-2014
#6
Byomesh Tripathi, Shilpkumar Arora, Varun Kumar, Mohamed Abdelrahman, Sopan Lahewala, Mihir Dave, Mahek Shah, Bryan Tan, Sejal Savani, Apurva Badheka, Radha Gopalan, Ghanshyam Palamaner Subash Shantha, Juan Viles-Gonzalez, Abhishek Deshmukh
BACKGROUND: Catheter ablation is widely accepted intervention for atrial fibrillation (AF) refractory to antiarrhythmic drugs, but limited data are available regarding contemporary trends in major complications and in-hospital mortality due to the procedure. This study was aimed at exploring the temporal trends of in-hospital mortality, major complications, and impact of hospital volume on frequency of AF ablation-related outcomes. METHODS: The Nationwide Inpatient Sample database was utilized to identify the AF patients treated with catheter ablation...
February 25, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29476433/prediction-of-hemodialysis-vascular-access-failure-using-segmental-bioimpedance-analysis-parameters
#7
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)...
May 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29432404/duration-to-establish-an-emergency-vascular-access-and-how-to-accelerate-it-a-simulation-based-study-performed-in-real-life-neonatal-resuscitation-rooms
#8
Eva M Schwindt, Florian Hoffmann, Philipp Deindl, Thomas J Waldhoer, Jens C Schwindt
OBJECTIVES: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. DESIGN: Retrospective analysis of audio-video recorded neonatal simulation training. SETTINGS: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany)...
February 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29421017/temporal-trends-in-patient-referral-for-transcatheter-aortic-valve-replacement-and-reasons-for-exclusion-at-a-high-volume-center-in-the-united-states
#9
Kyle D Buchanan, Toby Rogers, M Chadi Alraies, Arie Steinvil, Edward Koifman, Ricardo O Escárcega, Arpi Tavil-Shatelyan, Joelle Salmon, Jiaxiang Gai, Linzhi Xu, Rebecca Torguson, Petros Okubagzi, Augusto Pichard, Itsik Ben-Dor, Lowell F Satler, Ron Waksman
BACKGROUND: Clinical indications for transcatheter aortic valve replacement (TAVR) and elements of the implantation procedure, including delivery system miniaturization and novel access options, have evolved over time. The reasons patients are excluded from TAVR also have changed. The impact of these changes on patient referral for and exclusion from TAVR is unknown. METHODS: We retrospectively analyzed patients referred to our center for TAVR from January 2010 to August 2016 to evaluate reasons for patient exclusion...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29355988/variation-in-practice-patterns-and-outcomes-across-united-network-for-organ-sharing-allocation-regions
#10
Dushyanth Srinivasan, Benjamin Vaccaro, Pooja Rao, Rohit Ghosh, Prashant Warier, Tariq Ahmad, Nihar Desai
BACKGROUND: The number of heart transplants performed is limited by organ availability and is managed by the United Network for Organ Sharing (UNOS). Efforts are underway to make organ disbursement more equitable as demand increases. HYPOTHESIS: Significant variation exists in contemporary patterns of care, wait times, and outcomes among patients undergoing heart transplantation across UNOS regions. METHODS: We identified adult patients undergoing first, single-organ heart transplantation between January 2006 and December 2014 in the UNOS dataset and compared sociodemographic and clinical profiles, wait times, use of mechanical circulatory support (MCS), status at time of transplantation, and 1-year survival across UNOS regions...
January 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29354172/transcatheter-aortic-valve-implantation-at-a-high-volume-center-the-bad-rothenfelde-experience
#11
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
https://www.readbyqxmd.com/read/29299627/3d-vascular-anatomy-of-the-presacral-space-impact-of-age-and-adiposity
#12
Alexander A Berger, Steven Abramowitch, Pamela A Moalli
INTRODUCTION AND HYPOTHESIS: Defining patient characteristics that alter vascular anatomy at the sacrum is critical for avoiding life-threatening bleeding at the time of sacrocolpopexy. We tested the hypothesis that in thinner/older women, the bifurcations of the aorta and inferior vena cava (IVC) are lower relative to S1 resulting in less space accessible for suture/mesh placement, placing this group at increased risk of major vascular injury. METHODS: In a retrospective cross-sectional study, CT scans were used to make 2D measurements and a 3D model of the aorta/IVC, intervertebral disc space, and bony anatomy using segmentation and modeling software...
January 3, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29230568/ankle-brachial-pressure-index-as-a-predictor-of-the-2-year-outcome-after-transcatheter-aortic-valve-replacement-data-from-the-japanese-ocean-tavi-registry
#13
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
https://www.readbyqxmd.com/read/29198387/international-differences-in-the-location-and-use-of-arteriovenous-accesses-created-for-hemodialysis-results-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#14
Ronald L Pisoni, Lindsay Zepel, Richard Fluck, Charmaine E Lok, Hideki Kawanishi, Gültekin Süleymanlar, Haimanot Wasse, Francesca Tentori, Jarcy Zee, Yun Li, Douglas Schaubel, Steven Burke, Bruce Robinson
BACKGROUND: Vascular access practice is strongly associated with clinical outcomes. There is substantial international variation in the use of arteriovenous fistulas (AVFs) and grafts (AVGs), as well as AVF maturation time and location. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Hemodialysis patients participating in the prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) from the United States, Japan, and Europe/ANZ (Belgium, France, Germany, Italy, Spain, Sweden, United Kingdom, Australia, and New Zealand), including 3,850 patients receiving 4,247 new AVFs and 842 patients receiving 1,129 new AVGs in 2009 to 2015...
November 29, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29130399/recent-trends-in-publications-of-us-vascular-surgery-program-directors
#15
Afsha Aurshina, Anil Hingorani, Amrit Hingorani, Ayisha Zainab, Natalie Marks, Sheila Blumberg, Enrico Ascher
Objective In order to examine the academic productivity of US vascular surgery program directors, the number of vascular publications listed in PubMed from 2001 to 2015 for US vascular surgery program directors was reviewed. We suggest that this can be used as a benchmark for academic productivity. Methods The names of the program directors were taken from the Accreditation Council for Graduate Medical Education (ACGME) website at two time points: December 2009 (Independent Programs) and December 2015 (Independent + Integrated)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29107761/improved-limb-salvage-for-patients-with-vascular-disease-and-tissue-loss-associated-with-new-model-of-provision-targeted-at-the-diabetic-foot
#16
Dean T Williams, Anna Powell-Chandler, Quratulain Qureshi, Aeliya Zaidi, Christopher J Whitaker
AIMS: The establishment of a vascular surgeon-led emergency diabetic foot service in 2006 has evolved to provide lower limb wound care for patients with and without diabetes. We aimed to determine whether the service was associated with sustained, improved limb salvage rates for the whole population, analyse key aspects of service provision and compare outcomes against published studies. METHODS: The vascular unit serves a largely rural population of approximately 240,000...
January 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29076516/vascular-access-in-lipoprotein-apheresis-a-retrospective-analysis-from-the-uk-s-largest-lipoprotein-apheresis-centre
#17
Daniel J Doherty, Alison Pottle, George Malietzis, Nadey Hakim, Mahmoud Barbir, Jeremy S Crane
INTRODUCTION: Lipoprotein apheresis (LA) has proven to be an effective, safe and life-saving therapy. Vascular access is needed to facilitate this treatment but has recognised complications. Despite consistency in treatment indication and duration there are no guidelines in place. The aim of this study is to characterise vascular access practice at the UK's largest LA centre and forward suggestions for future approaches. METHODS: A retrospective analysis of vascular access strategies was undertaken in all patients who received LA treatment in the low-density lipoprotein (LDL) Apheresis Unit at Harefield Hospital (Middlesex, UK) from November 2000 to March 2016...
October 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29068164/predictors-of-in-hospital-effectiveness-and-complications-of-rotational-atherectomy-from-the-orpki-polish-national-registry-2014-2016
#18
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
https://www.readbyqxmd.com/read/29017461/feasibility-and-safety-of-early-discharge-after-transfemoral-transcatheter-aortic-valve-implantation-rationale-and-design-of-the-fast-tavi-registry
#19
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
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#20
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
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