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Arteriovenous Fistula Placement

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https://www.readbyqxmd.com/read/29784614/tradeoffs-in-vascular-access-selection-in-elderly-patients-initiating-hemodialysis-with-a-catheter
#1
Timmy Lee, Joyce Qian, Mae Thamer, Michael Allon
RATIONALE & OBJECTIVE: National vascular access guidelines recommend placement of arteriovenous fistulas (AVFs) over grafts (AVGs) in hemodialysis patients, but have not been comprehensively assessed in the elderly. We evaluated clinically relevant vascular access outcomes in elderly patients receiving an AVF or AVG after hemodialysis therapy initiation. STUDY DESIGN: Retrospective cohort study using national administrative data. SETTINGS & PARTCIPANTS: Claims data from the US Renal Data System of 9,458 US patients 67 years and older who initiated hemodialysis therapy from July 1, 2010, to June 30, 2011, with a catheter and received an AVF (n=7,433) or AVG (n=2,025) within the ensuing 6 months...
May 18, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29781238/improving-haemodialysis-fistula-maturation-following-early-ultrasound-vascular-mapping-the-venous-preservation-scan
#2
Ru Yu Tan, Michelle Manning, Jacqueline Spurway, Thulasi Jegatheesan, Michelle Bertram, Lisa Phipps, Jan Swinnen
AIM: Formation of autogenous arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD) is complicated by a high primary failure rate due to pre-existing vascular damage. We hypothesized that Venous Preservation Scan (VPS) - early (months to years before AVF creation) vascular mapping followed by vasculature preservation is effective in protecting the patient's best "for fistula" vasculature. This study was performed to evaluate the impact of VPS on AVF outcomes...
May 20, 2018: Nephrology
https://www.readbyqxmd.com/read/29730781/role-of-antiplatelet-therapy-in-the-durability-of-hemodialysis-access
#3
Satinderjit Locham, Robert J Beaulieu, Hanaa Dakour-Aridi, Besma Nejim, Mahmoud B Malas
BACKGROUND: Antiplatelet therapy (APT) is often used on anecdotal grounds to improve vascular access patency. The aim of this study was to assess the role of APT in hemodialysis (HD) patients undergoing arteriovenous fistula (AVF) or graft (AVG) placement. METHODS: All patients in a large HD vascular qualitative initiative database (2011-2017) were included and divided into no antiplatelet therapy (no-APT) vs. any APT [aspirin (ASA) or P2Y12 inhibitors (PI)]. Multivariate [logistic (MLR) and Cox (MCR) regression] analyses were used as appropriate...
May 5, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29722286/new-insertion-support-device-assisted-the-accurate-placement-of-tunneled-cuffed-catheter-first-experience-of-10-cases
#4
Toshiaki Ohara, Kazufumi Sakurama, Satoshi Hiramatsu, Toshimasa Karai, Toshiaki Sato, Yuta Nishina
INTRODUCTION: The tunneled cuffed catheter is used in hemodialysis patients for whom an arteriovenous fistula or arteriovenous graft is not suitable or for bridging usage of them. Accurate placement of a tunneled cuffed catheter is necessary for safe hemodialysis, but placement is sometimes difficult because of individual body differences. We developed a new device to support accurate placement of the tunneled cuffed catheter. In this study, we report our first clinical experience of the device...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29701407/creative-vascular-access-construction-in-same-patient
#5
Pedro Pinto Sousa, Paulo Almeida, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Creating and maintaining a functional vascular access(VA) is a critical factor in the survival of a dialysis patient. However, it will not function forever, implying a creative attitude from the vascular surgeon either to maintain its functionality or built a new one wherever possible, being it autologous or synthetic. METHODS: Describe the VA history of a 59years-old male with morbid obesity and end-stage chronic kidney disease. RESULTS: His VA construction started in2012 with failed attempts in both forearms until a functional brachiocephalic artery-venous fistula(AVF) in the right upper limb was achieved, but was deemed to ligation as severe venous hypertension secondary to central venous disease related to CVC use...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29686166/-percutaneous-transluminal-sinus-stenting-for-sigmoid-sinus-stenosis-associated-with-transverse-sigmoid-sinus-dural-arteriovenous-fistula-a-case-report
#6
Yoshiaki Tetsuo, Hiroyuki Matsumoto, Hirokazu Nishiyama, Hideki Takemoto, Naoyuki Nakao
We report a case of transverse sinus-sigmoid sinus dural arteriovenous fistula(T-S dAVF)with venous flow congestion, which was accompanied by sigmoid sinus stenosis and treated with percutaneous transluminal sinus stenting. A 76-year-old woman presented with dementia and disturbance of consciousness. Magnetic resonance imaging(MRI)on admission revealed subcortical edema in the left occipital lobe and angiography demonstrated a left T-S dAVF with right transverse sinus occlusion and sigmoid sinus stenosis. Hemodynamics of the shunt flow from several feeders demonstrated retrograde flow to the straight sinus and superior sagittal sinus, and antegrade flow into the left internal jugular vein...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29680304/spinal-dural-arteriovenous-fistula-assumed-to-be-symptomatic-after-placement-of-lumbar-cerebrospinal-fluid-drain
#7
Senshu Nonaka, Hidenori Oishi, Satoshi Tsutsumi, Koichiro Sakamoto, Hidehiro Okura, Takamoto Suzuki, Hisato Ishii, Yukimasa Yasumoto
A 69-year-old man presented with severe headache. Cranial computed tomography revealed diffuse subarachnoid hemorrhage. An anterior communicating artery aneurysm was identified and successfully obliterated by open microsurgery on the same day. Following placement of a continuous lumbar cerebrospinal fluid drain on hospitalization day 7, the patient developed a severe paraplegia and sensory loss below T6. Cerebral magnetic resonance imaging did not identify a responsible lesion. Spinal magnetic resonance imaging, however, showed extensive intramedullary hyperintensity on T2-weighted sequences...
April 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29624859/comparison-between-open-and-pharmacomechanical-repair-of-acutely-thrombosed-arteriovenous-hemodialysis-fistulae-within-a-decade
#8
Susanne Regus, Veronika Almási-Sperling, Ulrich Rother, Alexander Meyer, Axel Schmid, Michael Uder, Werner Lang
INTRODUCTION: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single-center study was to compare immediate and follow-up results between surgical repair and a modified interventional lyse-and-wait technique characterized by prolonged local reaction times of recombinant tissue-plasminogen activator (rtPA). MATERIALS AND METHODS: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013...
April 6, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29615350/a-technique-for-the-salvage-of-megafistulas-allowing-immediate-dialysis-access
#9
Nosratollah Nezakatgoo, Steven D Kozusko, Jefferson T Watson, Rebecca Empting, Charles P Shahan, Michael J Rohrer
OBJECTIVE: Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS: The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29577815/the-efficacy-of-drug-eluting-stent-for-recurrent-central-venous-restenosis-in-a-patient-undergoing-hemodialysis
#10
Sadanori Shintaku, Tomoyasu Sato, Hideki Kawanishi, Misaki Moriishi, Shinichiro Tsuchiya
INTRODUCTION: Recurrent central venous restenosis is problematic in patients with ipsilateral arteriovenous fistula. We report our experience using a drug-eluting stent for the treatment of recurrent central vein restenosis. CASE REPORT: A 60-year-old man consulted our hospital because of recurrent swelling of his left upper limb with radial-cephalic arteriovenous fistula that originated in the distal forearm. More than 3 years prior, two bare-metal stents were placed for the obstructed lesions in the left subclavian and brachiocephalic venous lesions, and repeated balloon angioplasty for recurrent in-stent stenosis was performed approximately every 3 months...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29567027/a-prospective-randomized-study-of-bovine-carotid-artery-biologic-graft-and-expanded-polytetrafluoroethylene-for-permanent-hemodialysis-access
#11
Hanaa Dakour Aridi, Isibor Arhuidese, Melissa Scudder, Thomas Reifsnyder, Mahmoud B Malas
OBJECTIVE: Arteriovenous grafts (AVGs) remain reliable substitutes for permanent hemodialysis access in scenarios that preclude the placement of native arteriovenous fistulas (AVFs). The majority of AVGs are constructed of expanded polytetrafluoroethylene (ePTFE), which is relatively inexpensive and readily available, but synthetic AVGs have poor patency rates. On the other hand, biologic grafts confer an advantage by virtue of their inherent similarity to the native human vasculature...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29552930/cardiac-implantable-electronic-device-and-vascular-access-strategies-to-overcome-problems
#12
Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29546793/resection-of-puncture-site-necrosis-over-an-arteriovenous-fistula-endoclamp-use-for-preservation-of-cannulation-sites
#13
Alexandros Mallios, William Jennings, Benoit Boura, Alessandro Costanzo, Myriam Combes
Skin necrosis overlying an arteriovenous fistula at the cannulation site is a common and potentially life-threatening problem, often associated with underlying aneurysm formation. Arteriovenous fistula-skin necrosis generally requires resection of surrounding skin margins and the underlying aneurysmal vessel wall, allowing repair with healthy tissue of the arteriovenous fistula in addition to closure of soft tissue and skin. In patients with insufficient fistula length, salvage of these arteriovenous fistulas may result in difficult or insurmountable cannulation issues leading to attempts at one-needle cannulation dialysis or, most often, catheter placement...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29542366/placement-issues-of-hemodialysis-catheters-with-pre-existing-central-lines-and-catheters
#14
Afsha Aurshina, Anil Hingorani, Ahmad Alsheekh, Pavel Kibrik, Natalie Marks, Enrico Ascher
OBJECTIVE: It has been a widely accepted practice that a previous placed pacemaker, automatic implantable cardioverter defibrillators, or central line can be a contraindication to placing a hemodialysis catheter in the ipsilateral jugular vein. Fear of dislodging pacing wires, tunneling close to the battery site or causing venous obstruction has been a concern for surgeons and interventionalists alike. We suggest that this phobia may be unfounded. METHODS: A retrospective review was conducted of patients in whom hemodialysis catheters were placed over a period of 10 years...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29526971/risk-of-heparin-induced-immediate-type-hypersensitivity-during-arteriovenous-fistula-placement
#15
Katsuhito Ihara, Atsuki Ohashi, Seiji Inoshita
Heparin is commonly used to prevent clotting; however, severe hypersensitivity reactions during vascular access (VA) placement are rarely but occasionally reported. A 49-year-old man experienced a heparin-induced hypersensitivity reaction during VA placement. Severe side effects may occur even while placing the VA; therefore, we reconsidered the routine use of heparin, as the side effects are unpredictable. Physicians should be aware of the risk of heparin-induced hypersensitivity and be ready to effectively manage it during VA placement...
March 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29525324/residential-area-life-expectancy-association-with-outcomes-and-processes-of-care-for-patients-with-esrd-in-the-united-states
#16
Jesse D Schold, Stuart M Flechner, Emilio D Poggio, Joshua J Augustine, David A Goldfarb, John R Sedor, Laura D Buccini
BACKGROUND: The effects of underlying noncodified risks are unclear on the prognosis of patients with end-stage renal disease (ESRD). We aimed to evaluate the association of residential area life expectancy with outcomes and processes of care for patients with ESRD in the United States. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult patients with incident ESRD between 2006 and 2013 recorded in the US Renal Data System (n=606,046)...
March 7, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29511569/vascular-access-practice-patterns-in-canada-a-national-survey
#17
Chance Dumaine, Mercedeh Kiaii, Lisa Miller, Louise Moist, Matthew J Oliver, Charmaine E Lok, Swapnil Hiremath, Jennifer M MacRae
Background: One of the mandates of the Canadian Society of Nephrology's (CSN) Vascular Access Working Group (VAWG) is to inform the nephrology community of the current status of vascular access (VA) practice within Canada. To better understand VA practice patterns across Canada, the CSN VAWG conducted a national survey. Objectives: (1) To inform on VA practice patterns, including fistula creation and maintenance, within Canada. (2) To determine the degree of consensus among Canadian clinicians regarding patient suitability for fistula creation and to assess barriers to and facilitators of fistula creation in Canada...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29506430/pregnancy-and-hemodialysis-access-a-case-for-patient-satisfaction-in-favor-of-a-tunneled-dialysis-catheter
#18
Sushil Mehandru, Attiya Haroon, Avais Masud, Mayurkumar Patel, Elmer Sadiang-Abay, Eric J Costanzo, Tushar J Vachharajani
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29481943/technique-to-avoid-hemodialysis-catheter-in-patients-with-failing-aneurysmal-arteriovenous-fistula-by-creating-a-concomitant-new-arteriovenous-fistula
#19
Kelly A Lara, Rochelle Anne Chua, Trung D Vo
Autogenous arteriovenous fistula (AVF) is the primary recommended access for hemodialysis. Long-term use will not uncommonly result in AVF aneurysmal degeneration. Aneurysm-associated complications encompass pain, skin ulceration, infection, thrombosis, cannulation difficulties, and life-threatening bleeding. Various methods to repair aneurysmal AVFs have been described. However, there may be circumstances when this is not possible and require insertion of a temporary hemodialysis catheter (HDC) until a new arteriovenous access is created...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29452835/a-comparison-of-preoperative-and-intraoperative-vein-mapping-sizes-for-arteriovenous-fistula-creation
#20
Samuel H Hui, Ryan Folsom, Lois A Killewich, Joel E Michalek, Mark G Davies, Lori L Pounds
BACKGROUND: Duplex ultrasound (DUS) mapping of the veins and arteries of the upper extremity is a well-established practice in arteriovenous fistula creation for long-term hemodialysis access. Previous publications have shown that vein diameters varying from 2 to 3 mm are predictive of success. Regional anesthesia is known to result in vasodilation and thus to increase the diameter of upper extremity veins. This study compares the sizes of veins measured by preoperative DUS mapping with those obtained after regional anesthesia to determine whether intraoperative DUS results in increased vein diameters and thus changes in the operative plan...
February 13, 2018: Journal of Vascular Surgery
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