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hemodialysis access

Matt Chiung-Yu Chen, Mei-Jui Weng, Huei-Lung Liang
PURPOSE: This study was performed to retrospectively assess the efficacy of percutaneous creation of an intervascular bypass with or without stent graft deployment (endovascular bypass) for salvage of abandoned vascular access sites in hemodialysis catheter-consigned patients. METHODS: Salvage of abandoned vascular access sites was attempted in 16 patients with hemodialysis catheters. These vascular access sites were salvaged using endovascular bypass techniques to redirect the access flow to a nonarterialized vein as a new outflow conduit or cannulation segment...
March 1, 2018: Journal of Vascular Access
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
Philip Gc Chan, Gerard S Goh
PURPOSE: The AngioJet Hemolytic Thrombectomy Device "AngioJet" (Boston Scientific, Malborough, MA, USA) is a rheolytic thrombectomy device that can be used in the treatment of hemodialysis arteriovenous fistula and graft thrombosis. We aim to appraise the current evidence on AngioJet thrombectomy in hemodialysis vascular access thrombosis, and to determine its safety, including complications and efficacy. MATERIALS AND METHODS: An electronic literature search was performed on the MEDLINE and Embase databases...
March 1, 2018: Journal of Vascular Access
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
Ryo Sato, Tetsuhiko Sato, Yuichi Shirasawa, Chika Kondo, Masao Tadakoshi, Michio Fukuda, Nobuyuki Ohte, Kunio Morozumi
OBJECTIVE: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt® ) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty...
March 1, 2018: Journal of Vascular Access
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
Yoko Kaneko, Takamoto Yanagawa, Yoshinori Taru, Sonoko Hayashi, Hong Zhang, Tomoki Tsukahara, Tsuneaki Matsunaga, Takashi Ishizu
INTRODUCTION: We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty. CASE DESCRIPTION: A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness...
March 1, 2018: Journal of Vascular Access
Kenneth Abreo, Mary Buffington, Bharat Sachdeva
The arteriovenous fistula is currently the best permanent access for the hemodialysis patient. Unfortunately, stenosis impairs maturation, long-term survival, and function of the arteriovenous fistula. Angioplasty currently is the best procedure for the treatment of immature and dysfunctional arteriovenous fistulas. In this review, the authors discuss the optimum time to evaluate arteriovenous fistulas for maturity, methods of evaluation for maturity, and the role of angioplasty in salvaging immature arteriovenous fistulas...
March 1, 2018: Journal of Vascular Access
Kenneth Abreo, Adrian Sequeira
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents...
March 1, 2018: Journal of Vascular Access
Hoon Suk Park, Joonsung Choi, Hyung Wook Kim, Jun Hyun Baik, Cheol Whee Park, Young Ok Kim, Chul Woo Yang, Dong Chan Jin
PURPOSE: The exchange from a non-tunneled hemodialysis catheter to a tunneled one over a guidewire using a previous venotomy has been reported to be safe. However, some concerns that it may increase infection risk prevent its clinical application. This approach seems particularly useful for acute kidney injury patients requiring initial renal replacement therapy, in whom we frequently worry about the choice of non-tunneled versus tunneled catheters. MATERIALS AND METHODS: From March 2012 to February 2016, 88 cases to receive the over-the-guidewire exchange method from a non-tunneled to a tunneled catheter and 521 cases to receive de novo tunneled catheter placement from the hemodialysis vascular access cohort were compared retrospectively...
March 1, 2018: Journal of Vascular Access
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
Amir A Ghaffarian, Ragheed Al-Dulaimi, Larry W Kraiss, Mark Sarfati, Claire L Griffin, Brigitte K Smith, Graham Donald, Benjamin S Brooke
OBJECTIVE: Arteriovenous (AV) fistulas are the preferred hemodialysis access for patients with end-stage renal disease, although multiple interventions are typically needed to maintain patency. When AV fistulas thrombose, however, there is debate as to whether open thrombectomy should be attempted, particularly for salvage of upper arm fistulas. This study was designed to evaluate outcomes after open thrombectomy of upper arm and forearm AV fistulas compared with AV grafts. METHODS: We identified all patients who underwent an open thrombectomy procedure for a thrombosed AV fistula or graft at a single academic medical center between January 2006 and March 2017...
March 8, 2018: Journal of Vascular Surgery
Cindy You, Shishir Sharma, Aakash Bavishi, Christopher A Groh, Yazan Alia, Basil Saour, Rod Passman
BACKGROUND: Hemodialysis (HD) patients have a high risk of sudden death but limited vascular access and high complication rates from transvenous implantable cardioverter-defibrillators (ICDs). Subcutaneous ICDs (S-ICD) may be an alternative, but dynamic ECG changes may result in inappropriate shocks. This study aims to define the screen failure rate for S-ICD in patients pre- and post-HD. METHODS: ECG waveforms were obtained using electrodes mimicking the S-ICD sensing vectors in an unselected test group of chronic HD patients and a control group of ICD-eligible non-dialysis patients...
March 10, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michael W M Gerrickens, Roel H D Vaes, Bastiaan Govaert, Joep A W Teijink, Marc R Scheltinga
INTRODUCTION: Some hemodialysis patients with a brachial arteriovenous fistula (AVF) have an unsuitable upper arm needle access segment (NAS) necessitating basilic vein transposition (BVT). It was frequently observed that a portion of these patients spontaneously experienced a warmer and less painful dialysis hand after BVT. Aim of this study was to determine whether BVT for an inadequate NAS attenuated hemodialysis access-induced distal ischemia in patients with a brachial AVF. METHODS: Patients with a brachial AVF and an unsuitable NAS also reporting hand ischemia and scheduled to undergo BVT between 2005 and 2016 in a single facility were studied...
March 8, 2018: Hemodialysis International
Almudena Vega, Soraya Abad, Inés Aragoncillo, Isabel Galán, Nicolás Macías, Santiago Cedeño, Alba Santos, Ana García, Tania Linares, María Martínez-Villaescusa, Juan M López-Gómez
Introduction It is important to monitor vascular access in patients with stage 5 chronic kidney disease receiving hemodialysis. Access recirculation can help to detect a need for intervention. OBJECTIVES: To compare urea recirculation with recirculation by thermodilution using blood temperature monitoring to predict a need for intervention of vascular access over a 6-month period. METHODS: We analyzed urea recirculation and blood temperature monitoring simultaneously in 61 patients undergoing hemodialysis...
March 1, 2018: Journal of Vascular Access
Chun-Fan Chen, Chih-Ching Lin
Some hemodialysis patients suffer from repeat dysfunction of dialysis vascular access and need procedures of angioplasty, thrombectomy, and even temporary catheter use. Why these patients are vulnerable to vascular access dysfunction and how to improve its patency are imperative to be discovered. Traditional risk factors for vascular access function had been widely investigated but could not fully explain this question. Several genotype polymorphisms were demonstrated to increase the incidence of cardiovascular disease and might also be linked to higher risk of vascular access dysfunction...
February 1, 2018: Journal of Vascular Access
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
Michael Koutouzis, George S Sfyroeras, Christos Maniotis, Konstantinos Kintis, Sotirios Patsilinakos, Panagiotis Tsiverdis, Giannis Giannikouris, Ioannis Tsiafoutis, Efstathios Lazaris, Michalis Hamilos
BACKGROUND: End-stage renal disease (ESRD) is considered a relative contraindication for forearm (radial or ulnar) cardiac catheterization. However, in everyday practice, many ESRD patients are catheterized from the forearm. The aim of this study was to compare femoral and forearm approach for cardiac catheterization in ESRD patients. METHODS: All cardiac catheterization procedures performed in ESRD patients in three Greek hospitals in a 2-year period (2014-2015) were retrospectively evaluated...
March 2018: Journal of Invasive Cardiology
Cemal Kocaaslan, Tamer Kehlibar, Mehmet Yilmaz, Mehmet E Mehmetoglu, Rafet Gunay, Mustafa Aldag, Bulend Ketenci, Mahmut M Demirtas
Introduction Guidelines have been recommending the use of arteriovenous fistula among the hemodialysis population, but no clear conclusion has emerged with regard to the adequate access type in octogenarians. In this paper, the outcomes of arteriovenous fistula in octogenarian cohort were presented for death-censored cumulative patency rate, complications, and patients' survival rate. Methods A retrospective review of 88 consecutive arteriovenous fistula interventions in 70 octogenarian patients were performed at one referral institution between January 2010 and June 2014...
January 1, 2018: Vascular
Surendra Shenoy, Michael Allon, Gerald Beathard, Deborah Brouwer-Maier, Laura M Dember, Mark Glickman, Celeste Lee, Terry Litchfield, Charmaine Lok, Thomas Huber, Prabir Roy-Chaudhury, Jack Work, Melissa West, Haimanot Wasse
No abstract text is available yet for this article.
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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