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Catheter related thrombosis

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https://www.readbyqxmd.com/read/28430315/adding-access-blood-flow-surveillance-reduces-thrombosis-and-improves-arteriovenous-fistula-patency-a-randomized-controlled-trial
#1
Inés Aragoncillo, Soraya Abad, Silvia Caldés, Yésika Amézquita, Almudena Vega, Antonio Cirugeda, Cristina Moratilla, José Ibeas, Ramón Roca-Tey, Cristina Fernández, Nicolás Macías, Borja Quiroga, Ana Blanco, Maite Villaverde, Caridad Ruiz, Belén Martín, Asunción M Ruiz, Jara Ampuero, Fernando de Alvaro, Juan M López-Gómez
PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#2
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28412100/risk-of-acute-kidney-injury-after-percutaneous-pharmacomechanical-thrombectomy-using-angiojet-in-venous-and-arterial-thrombosis
#3
Guillermo A Escobar, Dillon Burks, Matthew R Abate, Mohammed F Faramawi, Ahsan T Ali, Lewis C Lyons, Mohammed M Moursi, Matthew R Smeds
BACKGROUND: Percutaneous mechanical thrombectomy (PMT) is commonly used to treat acute thrombotic syndromes. Angiojet (AJ) forcibly sprays fibrinolytics to fragment and aspirate thrombus. It's known to cause hemolysis and gross hematuria, yet potential consequences to renal function after AJ remain unstudied. We sought to determine the risk of acute kidney injury (AKI) after AJ when compared to other lysis techniques. METHODS AND RESULTS: We retrospectively reviewed patients treated with thrombolysis over 5 years...
April 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28395416/-application-of-percutaneous-angiojet-thrombectomy-in-patients-with-acute-symptomatic-portal-and-superior-mesenteric-venous-thrombosis
#4
J H Song, X He, W S Lou, L Chen, G P Chen, H B Su, W Y Shi, T Wang, B X Zhao, J P Gu
Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV)...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28359216/revisiting-ultrasound-guided-subclavian-axillary-vein-cannulations
#5
Mourad H Senussi, Phani C Kantamneni, Ali Omranian, Mani Latifi, Tarik Hanane, Eduardo Mireles-Cabodevila, Neal F Chaisson, Abhijit Duggal, Ajit Moghekar
The Centers for Disease Control and Prevention guidelines for the prevention of catheter-related bloodstream infections suggest using "a subclavian site, rather than an internal jugular or a femoral site, in adult patients." This recommendation is based on evidence of lower rates of thrombosis and catheter-related bloodstream infections in patients with subclavian central venous catheters (CVCs) compared to femoral or internal jugular sites. However, preference toward a subclavian approach to CVC insertion is hindered by increased risk of mechanical complications, especially pneumothorax, when compared to other sites...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28355409/life-saving-vascular-access-in-vascular-capital-exhaustion-single-center-experience-in-intra-atrial-catheters-for-hemodialysis
#6
Marta Pereira, Noélia Lopez, Iolanda Godinho, Sofia Jorge, Estela Nogueira, Fernando Neves, Alice Fortes, António G Costa
INTRODUCTION: Intra-atrial catheter (IAC) placement through an open surgical approach has emerged as a life-saving technique in hemodialysis (HD) patients with vascular access exhaustion. OBJECTIVE: To assess the complications of IAC placement, as well as patient and vascular access survival after this procedure. METHODS: The authors retrospectively analyzed all seven patients with vascular capital exhaustion, without immediate alternative renal replacement therapy (RRT), who underwent IAC placement between January 2004 and December 2015 at a single center...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28355402/budd-chiari-syndrome-secondary-to-catheter-associated-inferior-vena-cava-thrombosis
#7
Gustavo N Araujo, Luciane M Restelatto, Carlos A Prompt, Cristina Karohl
INTRODUCTION: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. CASE REPORT: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28352625/inherited-thrombophilia-in-pediatric-venous-thromboembolic-disease-why-and-who-to-test
#8
REVIEW
C Heleen van Ommen, Ulrike Nowak-Göttl
Venous thromboembolic disease in childhood is a multifactorial disease. Risk factors include acquired clinical risk factors such as a central venous catheter and underlying disease and inherited thrombophilia. Inherited thrombophilia is defined as a genetically determined tendency to develop venous thromboembolism. In contrast to adults, acquired clinical risk factors play a larger role than inherited thrombophilia in the development of thrombotic disease in children. The contributing role of inherited thrombophilia is not clear in many pediatric thrombotic events, especially catheter-related thrombosis...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28352362/feasibility-of-continuous-catheter-directed-thrombolysis-using-low-dose-urokinase-in-combination-with-low-molecular-weight-heparin-for-acute-iliofemoral-venous-thrombosis-in-patients-at-risk-of-bleeding
#9
Guoping Chen, Wangyin Shi, Xu He, Wensheng Lou, Liang Chen, Jianping Gu
The present study aimed to examine the feasibility of catheter-directed thrombolysis (CDT) using continuous infusion of low-dose urokinase in combination with low molecular weight heparin (LMWH) for acute iliofemoral venous thrombosis. This retrospective analysis included patients with symptomatic acute iliofemoral venous thrombosis who received CDT using continuous infusion of low-dose urokinase in combination with LMWH within the past four years. Urokinase was administered at 1×10(4) U/h and 2×10(4) U/h in patients at high-risk and low-risk of bleeding, respectively...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28346468/endoluminal-dilatation-for-embedded-hemodialysis-catheters-a-case-control-study-of-factors-associated-with-embedding-and-clinical-outcomes
#10
Hari Talreja, Stephen Edward Ryan, Janet Graham, Manish M Sood, Adnan Hadziomerovic, Edward Clark, Swapnil Hiremath
BACKGROUND: With the increasing frequency of tunneled hemodialysis catheter use there is a parallel increase in the need for removal and/or exchange. A small but significant minority of catheters become embedded or 'stuck' and cannot be removed by traditional means. Management of embedded catheters involves cutting the catheter, burying the retained fragment with a subsequent increased risk of infections and thrombosis. Endoluminal dilatation may provide a potential safe and effective technique for removing embedded catheters, however, to date, there is a paucity of data...
2017: PloS One
https://www.readbyqxmd.com/read/28334494/complications-of-peripherally-inserted-central-catheters-in-advanced-cancer-patients-undergoing-combined-radiotherapy-and-chemotherapy
#11
Jun Xie, Linjie Xu, Xiaomin Xu, Yunjuan Huang
AIMS AND OBJECTIVES: This study aimed to identify whether patients with advanced cancers were at high risk of peripherally inserted central catheter (PICC)-related complications when treated with concurrent chemo-radiotherapy. BACKGROUND: PICCs are widely used in chemotherapy. However, catheter usage may elevate the risks of infections and thrombosis. It is important to identify the patients with high risk of PICC-related complications. To date, little is known about PICC-related complications in patients with advanced cancers and receiving concurrent chemo-radiotherapy...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28295984/safety-of-arteriovenous-fistulae-and-grafts-for-continuous-renal-replacement-therapy-the-michigan-experience
#12
Anas Al Rifai, Nidhi Sukul, Robert Wonnacott, Michael Heung
INTRODUCTION: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end-stage renal disease (ESRD) patients. METHODS: Single-center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access-related complications...
March 13, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28265408/catheter-related-thrombosis-diagnosed-by-computed-tomography
#13
Yohei Yamauchi, Akira Baba, Yumi Okuyama
Catheter-related bloodstream infection can be detected with CT. Although it is not mandatory for its diagnosis, it is strong evidence as a cause of fever if detected incidentally.
March 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28265129/deep-vein-thrombosis-interventions-in-cancer-patients
#14
REVIEW
Resmi Ann Charalel, Suresh Vedantham
The presence of cancer increases the risk of deep vein thrombosis (DVT), DVT recurrence, and treatment-related bleeding, and therefore offers distinctive clinical considerations when planning treatment. Anticoagulation with a low-molecular-weight heparin is the preferred initial and long-term therapy in cancer patients. Inferior vena cava filters may be used judiciously for patients with cancer-related DVT who have contraindications to anticoagulation or who exhibit breakthrough pulmonary embolism (PE) despite anticoagulation, but should be removed when the PE risk is felt to subside...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28263863/the-influence-of-surface-chemistry-on-adsorbed-fibrinogen-conformation-orientation-fiber-formation-and-platelet-adhesion
#15
Liudi Zhang, Brendan Casey, Dennis K Galanakis, Clement Marmorat, Shelby Skoog, Katherine Vorvolakos, Marcia Simon, Miriam H Rafailovich
Thrombosis is a clear risk when any foreign material is in contact with the bloodstream. Here we propose an immunohistological stain-based model for non-enzymatic clot formation that enables a facile screen for the thrombogenicity of blood-contacting materials. We exposed polymers with different surface chemistries to protease-free human fibrinogen. We observed that on hydrophilic surfaces, fibrinogen is adsorbed via αC regions, while the γ400-411 platelet-binding dodecapeptide on the D region becomes exposed, and fibrinogen fibers do not form...
March 2, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28243988/fotrocan-delphi-consensus-statement-regarding-the-prevention-and-treatment-of-cancer-associated-thrombosis-in-areas-of-uncertainty-and-low-quality-of-evidence
#16
P Jimenez-Fonseca, A Carmona-Bayonas, C Calderon, J Fontcuberta Boj, C Font, R Lecumberri, M Monreal, A J Muñoz Martín, R Otero, A Rubio, P Ruiz-Artacho, C Suarez Fernández, E Colome, P Pérez Segura
INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method...
February 27, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28218366/peripherally-inserted-central-catheter-related-complications-in-cancer-patients-a-prospective-study-of-over-50-000-catheter-days
#17
Junren Kang, Wei Chen, Wenyan Sun, Ruibin Ge, Hailong Li, Enling Ma, Qingxia Su, Fang Cheng, Jinhua Hong, Yuanjuan Zhang, Cheng Lei, Xinchuan Wang, Aiyun Jin, Wanli Liu
PURPOSE: To evaluate incidence and risk factors of peripherally inserted central catheter (PICC)-related complications in cancer patients. METHODS: A prospective, multicenter, cohort study of cancer patients with PICC insertion was performed from February 1, 2013 to April 24, 2014. All patients were monitored in clinic until PICCs were removed. The primary endpoint was PICC removal due to complications. Patient-, catheter- and insertion-related factors were analyzed in univariable and multivariable logistic regression analysis to identify significant independent risk factors for PICC-related complications...
March 21, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#18
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28163887/central-venous-access-related-adverse-events-after-trabectedin-infusions-in-soft-tissue-sarcoma-patients-experience-and-management-in-a-nationwide-multi-center-study
#19
Michiel C Verboom, Jan Ouwerkerk, Neeltje Steeghs, Jacob Lutjeboer, J Martijn Kerst, Winette T A van der Graaf, Anna K L Reyners, Stefan Sleijfer, Hans Gelderblom
BACKGROUND: Trabectedin has shown efficacy against soft tissue sarcomas (STS) and has manageable toxicity. Trabectedin is administered through central venous access devices (VAD), such as subcutaneous ports with tunneled catheters, Hickman catheters and PICC lines. Venous access related adverse events are common, but have not yet been reported in detail. METHODS: A retrospective analysis of patient files of STS patients receiving trabectedin monotherapy between 1999 and 2014 was performed in all five STS referral centers in the Netherlands...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28149507/complications-with-peripherally-inserted-central-catheters-piccs-used-in-hospitalized-patients-and-outpatients-a-prospective-cohort-study
#20
Delphine Grau, Béatrice Clarivet, Anne Lotthé, Sébastien Bommart, Sylvie Parer
BACKGROUND: Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients and among outpatients. Despite many advantages, PICC-related complications can occur such as infection, thrombosis or mechanical complications. We aimed to evaluate rates and nature of PICC-related complications from insertion to removal and analyze risk factors of complications at baseline and during healthcare. METHODS: We performed a prospective cohort study looking at PICC-related complication rates in the inpatient and outpatient settings of 163 patients over a 7-month period...
2017: Antimicrobial Resistance and Infection Control
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