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haemodialysis access

Nicholas Inston, Harry Schanzer, Matthias Widmer, Colin Deane, Jason Wilkins, Ingemar Davidson, Paul Gibbs, Jeurgen Zanow, Pierre Bourquelot, Domenico Valenti
Arteriovenous access ischaemic steal (AVAIS) is a serious and not infrequent complication of vascular access. Pathophysiology is key to diagnosis, investigation and management. Ischaemia distal to an AV access is due to multiple factors. Clinical steal is not simply blood diversion but pressure changes within the adapted vasculature with distal hypoperfusion and resultant poor perfusion pressures in the distal extremity. Reversal of flow within the artery distal to the AV access may be seen but this is not associated with ischaemia in most cases...
October 12, 2016: Journal of Vascular Access
Silvia Calviño Günther, Carole Schwebel, Rebecca Hamidfar-Roy, Agnès Bonadona, Maxime Lugosi, Claire Ara-Somohano, Clémence Minet, Leïla Potton, Jean-Charles Cartier, Aurelien Vésin, Magalie Chautemps, Lenka Styfalova, Stephane Ruckly, Jean-François Timsit
PURPOSE: To describe all post-insertion complications involving most used intravascular access, and to determine whether the use of a new-generation transparent dressing (3M™ IV Advanced) might reduce their number and impact on ICU patient outcomes. METHODS: Patients older than 18, with an expected length of stay ≥48 h and requiring at least one central venous catheter (CVC), arterial catheter (AC), haemodialysis catheter (HDC), pulmonary arterial catheters (PAC) or peripheral venous catheter (PVC) were randomized into two groups: a new-generation transparent dressing, or the hospital's classical transparent dressing, and were followed daily for any infectious and non-infectious complications...
October 12, 2016: Intensive Care Medicine
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
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
Carlo Basile, Luigi Vernaglione, Francesco Casucci, Pasquale Libutti, Piero Lisi, Luigi Rossi, Valentina Vigo, Carlo Lomonte
BACKGROUND: Satisfactory vascular access flow (Qa) of an arteriovenous fistula (AVF) is necessary for haemodialysis (HD) adequacy. The aim of the present study was to further our understanding of haemodynamic modifications of the cardiovascular system of HD patients associated with an AVF. The main objective was to calculate using real data in what way an AVF influences the load of the left ventricle (LLV). METHODS: All HD patients treated in our dialysis unit and bearing an AVF were enrolled into the present observational cross-sectional study...
October 2016: Clinical Kidney Journal
Ramony Chan, Blake F Dear, Nick Titov, Josephine Chow, Michael Suranyi
OBJECTIVE: Treating depression among patients with chronic kidney disease (CKD) is imperative because of its high prevalence and health-related costs. However, many patients with CKD experience significant barriers to effective face-to-face psychological treatments. Internet-delivered cognitive behaviour therapy (iCBT) may help overcome the treatment barriers. The aim of the present study was to explore the acceptability and preliminary efficacy of iCBT for depression and anxiety among patients with CKD on haemodialysis...
October 2016: Journal of Psychosomatic Research
Ashwal Adamane Jayaram, Padmakumar Ramachandran, Tom Devasiya, Abdul Razak Uddina Kumeri, Umesh Pai
Innominate vein stenosis or thrombotic occlusion can occur in dialysis patients. Central vein stenosis is a common problem in patients on dialysis. Placement of a central vein catheter for dialysis access increases the risk of central vein stenosis. Central vein stenosis sometimes can jeopardize the arteriovenous fistula and arteriovenous graft in the ipsilateral extremity unless recognized early and treated. We describe three patients with left innominate vein stenosis who were known case of chronic kidney disease on haemodialysis and had a left brachio-cephalic fistula and presented with unilateral facial and upper limb oedema...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Shefali Gupta, Shrikara P Mallya, Ashok Bhat, Shrikala Baliga
INTRODUCTION: Aerobic bacterial infections often complicate vascular access in patients receiving haemodialysis, leading to Catheter-Related Blood Stream Infections (CRBSI). Various studies report Gram - positive bacteria, Staphylococcus aureus (S. aureus) in particular, as the most common aetiologic agent. Studies on microbiological analysis in this subset of population from India are very few. AIM: To examine clinical and bacteriological profiles of haemodialysis patients developing CRBSI, the antibiotic susceptibility of the bacteria isolated from these patients and determine nasal carriage of S...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
V A Batrashov, É N Manafov
A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lost with time would eventually and unavoidably result in exhaustion of the vascular recourses of the patient thus creating posing a problem while forming yet another PVA. Taking into consideration vitally important necessity of carrying out haemodialysis procedures for these patients, vascular surgeons have to search for alternative variants of access to the vascular bed...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Dr Charlotte Ratcliff, Miss Monica Hansrani
INTRODUCTION: This case report intends to highlight the Haemodialysis Reliable Outflow (HeRO) graft as a potential long term option for ongoing dialysis in patients with central venous stenosis. PRESENTATION OF CASE: A 55year old patient, who developed end stage renal failure (ESRF) after chemotherapy treatment for breast cancer, presented at the limit of her dialysis access after a 15year haemodialysis history causing central vein stenosis. The patient was initially started on peritoneal dialysis but after repeated peritonitis was switched to haemodialysis...
2016: International Journal of Surgery Case Reports
David Fulker, Anne Simmons, Tracie Barber
Arteriovenous fistulae (AVF) are the favoured choice of vascular access but still have poor long term success. Haemodynamic parameters play an important role in vascular health and have been linked to the development of intimal hyperplasia (IH), a pathological growth of the blood vessel initiated by injury. This study aimed to investigate the haemodynamics surrounding the arterial needle (AN) and venous needle (VN), using computational fluid dynamics. A range of blood flow rates, needle positions and needle orientations were examined...
August 16, 2016: Journal of Biomechanical Engineering
Jihene Fendri, Laura Palcau, Lucie Cameliere, Olivier Coffin, Aurelien Felisaz, Djelloul Gouicem, Julie Dufranc, Damien Laneelle, Ludovic Berger
: The donor artery after a long-standing arteriovenous fistula (AVF) for hemodialysis usually evolves exceptionally towards a true aneurysmal degeneration. OBJECTIVE: The purpose of this paper was to describe true brachial artery AD in ESRD patients after AVF creation, as well as its influencing factors and treatment strategies. MATERIAL AND METHOD: We present a retrospective, observational, single centre study realized in Caen University Hospital's Vascular Surgery Department from May 1996 to November 2015...
August 12, 2016: Annals of Vascular Surgery
Rukshana Shroff, Rosalie B Sterenborg, Adam Kuchta, Andrew Arnold, Nicholas Thomas, Lynsey Stronach, Soundrie Padayachee, Francis Calder
BACKGROUND: Arteriovenous fistula (AVF) formation for long-term haemodialysis in children is a niche discipline with little data for guidance. We developed a dedicated Vascular Access Clinic that is run jointly by a transplant surgeon, paediatric nephrologist, dialysis nurse and a clinical vascular scientist specialised in vascular sonography for the assessment and surveillance of AVFs. We report the experience and 2-year outcomes of this clinic. METHODS: Twelve new AVFs were formed and 11 existing AVFs were followed up for 2 years...
August 7, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Michael K O'Reilly, David Ryan, Gavin Sugrue, Tony Geoghegan, Leo P Lawler, Cormac T Farrelly
PURPOSE: Transradial pneumatic compression devices can be used to achieve haemostasis following radial artery puncture. This article describes a novel technique for acquiring haemostasis of arterio-venous haemodialysis fistula access sites without the need for suture placement using one such compression device. MATERIALS AND METHODS: A retrospective review of fistulograms with or without angioplasty/thrombectomy in a single institution was performed. 20 procedures performed on 12 patients who underwent percutaneous intervention of failing or thrombosed arterio-venous fistulas (AVF) had 27 puncture sites...
August 4, 2016: Cardiovascular and Interventional Radiology
Yi-Ju Ho, Chi-Hsiao Yeh, Chi-Chun Lai, Jerry Chien-Chieh Huang, Lan-Hsin Chuang
BACKGROUND: The aim of this study was to clarify the pathogenic mechanism and to evaluate an intervention for intractable secondary glaucoma in superior vena cava (SVC) syndrome. CASE PRESENTATION: A 66-year-old female with underlying hypertension, diabetes mellitus, ischaemic heart disease and end-stage renal disease complained of bilateral puffy eyelids for 3 months. Over three years, the patient experienced a progressive, marked face and neck swelling, which was accompanied by dyspnoea and nocturnal coughing...
2016: BMC Ophthalmology
Vladimir Pushevski, Petar Dejanov, Vesna Gerasimovska, Gordana Petrushevska, Angel Oncevski, Aleksandar Sikole, Zivko Popov, Ninoslav Ivanovski
BACKGROUND: Hemodialysis as an efficient therapy for advanced CKD is the most used treatment modality all over the world. Even though primary AVF is widely accepted as a best permanent vascular access in hemodialysis patients, up to 60% of all fistulas fail to mature. The pathogenesis of early fistula failure is not very well understood. Many general and local factors are involved: patient's age, sex, primary renal disease, small vessel's diameter, presence of accessory veins, prior venipunctures, surgical skill, genetics, etc...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Lewis Meecham, Owain Fisher, George Kirby, Richard Evans, Pauline Buxton, Jocelyn Legge, Sriram Rajagopalan, John Asquith, Arun Pherwani
PURPOSE: We present a case of external iliac vein patch venoplasty to accommodate rescue vascular access via a PTFE loop arterio-venous fistula Graft (AVG) for a patient with multiple central venous stenoses. METHODS: A 35 year old female with anti-glomerular basement membrane antibody disease required rescue vascular access for haemodialysis. Repeated occlusion and/or thrombosis of long term central venous access canulae, to facilitate dialysis, had caused stenosis of brachiocephalic veins; right external iliac vein and occlusion of the left common iliac vein...
July 13, 2016: Annals of Vascular Surgery
Julie Y Chen, Eric Y F Wan, Karina H Y Chan, Anca K C Chan, Frank W K Chan, Cindy L K Lam
BACKGROUND: Haemodialysis (HD) is one of the life-saving options for patients with end stage renal disease but demand for this treatment exceeds capacity in publicly funded hospitals. One novel approach to addressing this problem is through a shared-care model whereby government hospitals partner with qualified private HD service providers to increase the accessibility of HD for needy patients. The aim of this study is to evaluate and enhance the quality of care (QOC) provided in such a shared-care programme in Hong Kong, the Haemodialysis Public-Private Partnership Programme (HD-PPP)...
2016: BMC Nephrology
Nicola Pirozzi, Jose Garcia Medina, Paolo Menè
Distal radio-cephalic arteriovenous fistula is the 'gold standard' vascular access for chronic hemodialysis. Its main drawback is early failure, which can complicate up to 50 % of this surgical procedure. Two scenarios of failure are possible: early post-operative thrombosis or impaired maturation. The first is mainly due to a defective preoperative evaluation or poor surgical procedure. The latter is a patent angioaccess unable to deliver adequately hemodialysis due to a persistently low blood flow or difficult cannulation...
July 7, 2016: Journal of Nephrology
William Ngatchou, Achille Ngbwa Evina, Marie Patrice Halle, Annie Massom, Samuel Ekane, Essola Basile, Pierre Origer, Jean Pierre Haquebard, Alain Olinga Olinga, Jean Luc Jansens, Alain Watel, Antoine Lecain, Maimouna Bol Alima, Alexandra Van Uytvanck, Bernard Segers, Lionel Haentjens, Jacques Berre, Ousmane Bal, Nicolas Preumont, Justin Kana, Félicité Kamdem, Romuald Hentchoya, Pauline Etori, Brown Ndofor, Henri Ngote, Adamo Kasum, Aminata Coulibaly, Marie Solange Doualla, Henry Luma, Elie Cogan, Eric Lebrun, Gauthier Gamela, Olivier Germay, Albert Mouelle, Eugène Belley Priso, Anastase Dzudie, Daniel Lemogoum, Philippe Dehon
Background Chronic Kidney disease is a major health problem in the world. Native arteriovenous Fistula (AVF) is well established as the best vascular access for haemodialysis. Little is known about the outcome of AVF in sub-Saharan Africa. We aim to analyze the outcome of patients undergoing AVF creation during the pilot program established at the Douala general hospital (DGH). Method This was hospital-based, longitudinal study with a retrospective phase (April 2010-January 2014) and a prospective phase (January 2014-April 2014)...
February 2016: Acta Chirurgica Belgica
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