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Av fistula complications

Eleanor Murray, Mahmoud Eid, Jamie P Traynor, Karen S Stevenson, Ram Kasthuri, David B Kingsmore, Peter C Thomson
Background: The modality by which haemodialysis (HD) is delivered [arteriovenous fistula (AVF), arteriovenous graft (AVG) or central venous catheter (CVC)] varies widely and is influenced by clinical evidence, patient factors and the prevailing service configuration. The aim of this study was to determine the outcome and impact of access strategy on patient outcome by mapping out the HD journey in a cohort of incident patients. Methods: A 2-year cohort of consecutive incident HD patients from the point of referral for first dialysis access to completion of the first 365 days of HD was prospectively reviewed...
February 1, 2018: Nephrology, Dialysis, Transplantation
Goutham Talari, Preetham Talari, Saurabh Parasramka, Aibek E Mirrakhimov
Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea-azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay...
January 23, 2018: BMJ Case Reports
Stephanie Fichtner, Heidi L Estner, Marijana Dzijan-Horn, Judith Herber, Konstantinos D Rizas, Tilko Reents, Sonia Ammar, Verena Semmler, Stefan Kääb, Gabriele Hessling, Isabel Deisenhofer
PURPOSE: In some patients, both an electrophysiological examination (EPS) and a coronary angiography (CA) are necessary. It might be preferable to choose a combined approach of EPS and CA versus performing them consecutively. The purpose of this study is to evaluate the type and rate of adverse events between both approaches. METHODS: Patients were eligible if they underwent a CA and an EPS in a combined approach or in a time interval of at most 2 months. In all patients, clinical adverse events were recorded...
December 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Nicholas Inston, Hiren Mistry, James Gilbert, David Kingsmore, Zahid Raza, Matteo Tozzi, Ali Azizzadeh, Robert Jones, Colin Deane, Jason Wilkins, Ingemar Davidson, John Ross, Paul Gibbs, Dean Huang, Domenico Valenti
A master class was held at the Vascular Access at Charing Cross (VA@CX2017) conference in April 2017 with invited experts and active audience participation to discuss arteriovenous (AV) vascular access aneurysms, a serious and common complication of vascular access (VA). The natural history of aneurysms in VA is poorly defined, and although classifications exist they are not uniformly applied in studies or clinical practice. True and pseudo aneurysms of AV access occur. Whilst an AV fistula by definition is an abnormal dilatation of a blood vessel, an agreed definition of 18 mm, or 3 times accepted maturation diameter, is proposed...
November 17, 2017: Journal of Vascular Access
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
Khagendra Dahal, Jharendra Rijal, Ravi Shahukhal, Sharan Sharma, Hussam Watti, Michael Azrin, Pavan Katikaneni, Enrique Jimenez, Neeraj Tandon, Kalgi Modi, Juyong Lee
OBJECTIVES: To compare the efficacy and safety of manual compression (MC) with vascular hemostasis devices (VHD) in patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) through femoral artery access. INTRODUCTION: The use of femoral artery access for coronary procedures may result in access-related complications, prolonged immobility and discomfort for the patients. MC results in longer time-to-hemostasis (TTH) and time-to-ambulation (TTA) compared to VHDs but its role in access-related complications remains unclear in patients undergoing coronary procedures...
August 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Sanjith Aaron, Anupriya Arthur, A T Prabakhar, Pavitra Mannam, N K Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts...
July 2017: Annals of Indian Academy of Neurology
Martin Rabellino, Guillermo J Rosa-Diez, Sergio A Shinzato, Pablo Rodriguez, Oscar A Peralta, Maria S Crucelegui, Rosario Luxardo, Agustina Heredia-Martinez, Mariela I Bedini-Rocca, Ricardo D García-Mónaco
INTRODUCTION AND PURPOSE: The increasing number of patients undergoing hemodialysis and the limited number of access sites have resulted in an increasing number of techniques to maintain vascular access for hemodialysis. Thrombosed arteriovenous (AV) fistulas with large venous aneurysms have poor treatment results, with both endovascular and surgical techniques, leading to a high rate of definitive AV access loss. The purpose of this study was to review the feasibility and initial results of this novel endovascular treatment of thrombosed AV fistulas with large venous aneurysms...
2017: International Journal of Nephrology and Renovascular Disease
Edvard Skripochnik, David J O'Connor, Eric B Trestman, Evan C Lipsitz, Larry A Scher
Objectives The modern era of hemodialysis access surgery began with the publication in 1966 by Brescia et al. describing the use of a surgically created arteriovenous fistula. Since then, the number of patients on chronic hemodialysis and the number of publications dealing with hemodialysis access have steadily increased. We have chronicled the increase in publications in the medical literature dealing with hemodialysis access by evaluating the characteristics of the 50 most cited articles. Methods We queried the Science Citation Index from the years 1960-2014...
January 1, 2017: Vascular
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Violeta Mattea, Carsten Salomon, Niels Menck, Philipp Lauten, Frank Michael Malur, Anja Schade, Frank Steinborn, Lisa Costello-Boerrigter, Axel Neumeister, Harald Lapp
BACKGROUND: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. METHODS AND RESULTS: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times...
March 2017: IJC Heart & Vasculature
Thorsten H Ecke, Dimitri Barski, Guido Weingart, Carsten Lange, Steffen Hallmann, Jürgen Ruttloff, Friedhelm Wawroschek, Holger Gerullis
INTRODUCTION: This study addresses minimally invasive anesthesiologic and analgetic approaches for stone surgery in the upper urinary tract. Aim of this retrospective analysis is to compare feasibility, safety and complication rates of percutaneous nephrolithotomy (PCNL) under local infiltration anesthesia alone (Group I) and additive intravenous analgetics and/or sedative medications (Group II). MATERIAL AND METHODS: This is a single center study. A total of 439 patients have been included from November 2003 until March 2012...
2017: International Journal of Medical Sciences
Lars Kamper, Patrick Haage
Impaired fistula maturation is associated with puncture-related complications, insufficient dialysis and potential permanent access failure. Non-maturation is frequently initiated by stenotic vascular access vessels comprising the outflow veins, the arteriovenous anastomosis and infrequently the inflow artery. Further findings in maturation protraction are central venous stenoses or accessory outflow veins. Depending on the underlying pathology, several endovascular approaches to boost fistula maturation are possible...
March 6, 2017: Journal of Vascular Access
Stefan E Hardt, Andreas Eicken, Felix Berger, Stephan Schubert, Mario Carminati, Gianfranco Butera, Jochen Grohmann, Rene Höhn, Jens Erik Nielsen-Kudsk, David Hildick-Smith, Magnus Settergren, John D Thomson, Nicolas Geis, Lars Søndergaard
AIMS: The GORE® CARDIOFORM Septal Occluder (GSO) is a novel device designed for rapid and effective closure of patent foramen ovale (PFO) which has distinctive features making it suitable for a broad spectrum of anatomical variations. We report the procedural and 6 months follow-up results of the first prospective, multicenter study using GSO. METHODS AND RESULTS: This single-arm study included 150 subjects undergoing closure of PFO in 10 European centers. In 149 out of 150 patients implantation of a GSO device was successful...
March 15, 2017: Catheterization and Cardiovascular Interventions
Hassan Al-Thani, Ayman El-Menyar, Noora Al-Thani, Mohammad Asim, Ahmed Hussein, Ahmed Sadek, Ahmed Sharaf, Amr Fares
BACKGROUND: To investigate the clinical characteristics, surgical interventions, and outcomes of arteriovenous fistula (AVF) aneurysms, we retrospectively analyzed patients on regular hemodialysis (HD). METHODS: We conducted a cohort study of all patients with HD access who presented with AVF aneurysms and underwent operative procedures over a 11-year period. Patients' demographics, comorbidities, vascular access characteristics, management of aneurysms, complications, and outcomes were analyzed...
May 2017: Annals of Vascular Surgery
Anna Machowska, Mark D Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul R Qureshi, Bengt Lindholm, Peter Rutherford
INTRODUCTION: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients. METHODS: In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients...
March 16, 2017: International Journal of Artificial Organs
Erica Simon, Brit Long, Kyle Johnston, Shane Summers
BACKGROUND: Chronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result of the National Kidney Foundation's "Fistula First" initiative, nearly 55% of HD patients utilize an AV fistula. As there is significant morbidity and mortality associated with fistula placement and recurrent fistula cannulation, emergency physicians must be equipped to recognize and treat fistula complications...
December 10, 2016: Journal of Emergency Medicine
S Sheetal, P Byju, P Manoj
Ischemic monomelic neuropathy is an uncommon complication associated with the creation of arteriovenous (AV) fistula for hemodialysis. After placement of an arteriovenous fistula, there can be shunting of arterial blood away from the distal extremity resulting in damage to distal nerve fibers with acute neurologic symptoms. It can present with global muscle pain, weakness, and a warm hand with palpable pulses starting within the 1 st h after the creation of the AV fistula. It is a devastating complication and can result in permanent disability...
January 2017: Journal of Postgraduate Medicine
Samir F Zohny, Mahmoud Abd El-Fattah, Jalaluddin A Khan
PURPOSE: Thrombosis of native arteriovenous (AV) fistula is an important cause of complications in hemodialysis (HD) patients. The purpose of this study was to investigate the usefulness of measuring circulating fibroblast growth factor-23 (FGF-23) level and paraoxonase-1 (PON1) lactonase activity as potential predictors of native AV fistula thrombosis in chronic HD patients. METHODS: This study included 83 HD patients (48 with thrombosed and 35 with non-thrombosed native AV fistulas) and 38 healthy volunteers...
October 14, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
Hideyuki Hasebe, Akira Takanohashi, Kazuaki Shirota, Hajime Nakamura
Atrioventricular (AV) block and pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) are rare complications of infective endocarditis (IE). A 72-year-old man with severe aortic stenosis was hospitalized due to IE. After admission, intermittent AV block and P-MAIVF were noted. Interestingly, an accelerated junctional rhythm was observed during the process of AV block resolution. Elective surgery, which included patch closure of the fistula and replacement of the aortic valve, was successfully performed...
2016: Internal Medicine
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