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https://www.readbyqxmd.com/read/28710090/the-clinical-and-economic-effect-of-vascular-access-selection-in-patients-initiating-hemodialysis-with-a-catheter
#1
Alian Al-Balas, Timmy Lee, Carlton J Young, Jeffrey A Kepes, Jill Barker-Finkel, Michael Allon
Patients in the United States frequently initiate hemodialysis with a central venous catheter (CVC) and subsequently undergo placement of a new arteriovenous fistula (AVF) or arteriovenous graft (AVG). Little is known about the clinical and economic effects of initial vascular access choice. We identified 479 patients starting hemodialysis with a CVC at a large medical center (during 2004-2012) who subsequently had an AVF (n=295) or AVG (n=105) placed or no arteriovenous access (CVC group, n=71). Compared with patients receiving an AVG, those receiving an AVF had more frequent surgical access procedures per year (1...
July 14, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28708199/management-of-transposed-arteriovenous-fistula-swing-point-stenosis-at-the-basilic-vein-angle-of-transposition-by-stent-grafts
#2
George M Nassar, Gerald Beathard, Edward Rhee, Abdul Jabbar Khan, Binh Nguyen
INTRODUCTION: Transposed basilic vein arteriovenous fistulas suffer from stenosis at their basilic angle of transposition (BAT). This lesion exhibits frequent recurrence after angioplasty. The primary goal of this study was to determine the effect of stent-graft placement on BAT lesion- and access-patency. The secondary goals were to determine the frequency of intervention pre- and post-stent placement and stent-associated stenosis. METHODS: Thirty-seven cases had stent-grafts placed at their BAT to manage stenosis...
July 5, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28705077/fifty-years-of-hemodialysis-access-literature-the-fifty-most-cited-publications-in-the-medical-literature
#3
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
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#4
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28695442/fistula-first-initiative-historical-impact-on-vascular-access-practice-patterns-and-influence-on-future-vascular-access-care
#5
Timmy Lee
The vascular access is the lifeline for the hemodialysis patient. In the United States, the Fistula First Breakthrough Initiative (FFBI) has been influential in improving use of arteriovenous fistulas (AVF) in prevalent hemodialysis patients. Currently, prevalent AVF rates are near the goal of 66% set forth by the original FFBI. However, central venous catheter (CVC) rates remain very high in the United States in patients initiating hemodialysis, nearly exceeding 80%. A new direction of the of the FFBI has focused on strategies to reduce CVC use, and subsequently the FFBI has now been renamed the "Fistula First-Catheter Last Initiative"...
July 10, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28680825/the-feasibility-of-surgical-salvage-of-thrombosed-arteriovenous-fistula-by-an-interventional-nephrologist
#6
Seong Cho
BACKGROUND: Salvage of a thrombosed arteriovenous fistula (AVF) by secondary fistula conversion may be more effective than a conventional endovascular procedure for forearm fistula thrombosis. Surgical access procedures are an undeveloped area in interventional nephrology compared to endovascular procedures. Herein, the author report the results of surgical salvage of thrombosed AVFs by interventional nephrologists. METHODS: The author retrospectively analyzed 52 surgical salvage procedures for AVF thrombosis (radiocephalic fistula = 44 cases, brachiocephalic fistula = 8 cases) that were performed by interventional nephrologist between March 2007 and January 2016...
June 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28673467/fatal-dialysis-vascular-access-hemorrhage
#7
Matthew D Jose, Mark R Marshall, Gail Read, Nicole Lioufas, Jon Ling, Paul Snelling, Kevan R Polkinghorne
Bleeding from dialysis vascular access (arteriovenous fistulas, arteriovenous grafts, and vascular catheters) is uncommon. Death from these bleeds is rare and likely to be under-reported, with incident rates of fewer than 1 episode for every 1,000 patient-years on dialysis, meaning that dialysis units may experience this catastrophic event only once a decade. There is an opportunity to learn from (and therefore prevent) these bleeding deaths. We reviewed all reported episodes of death due to vascular access bleeding in Australia and New Zealand over a 14-year period together with individual dialysis units' root cause analyses on each event...
June 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#8
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
https://www.readbyqxmd.com/read/28663227/national-healthcare-safety-network-nhsn-dialysis-event-surveillance-report-for-2014
#9
Duc B Nguyen, Alicia Shugart, Christi Lines, Ami B Shah, Jonathan Edwards, Daniel Pollock, Dawn Sievert, Priti R Patel
BACKGROUND AND OBJECTIVES: Persons receiving outpatient hemodialysis are at risk for bloodstream and vascular access infections. The Centers for Disease Control and Prevention conducts surveillance for these infections through the National Healthcare Safety Network. We summarize 2014 data submitted to National Healthcare Safety Network Dialysis Event Surveillance. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Dialysis facilities report three types of dialysis events (bloodstream infections; intravenous antimicrobial starts; and pus, redness, or increased swelling at the hemodialysis vascular access site)...
June 29, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28657669/does-the-use-of-arteriovenous-loops-increase-complications-rates-in-posttraumatic-microsurgical-lower-extremity-reconstruction-a-matched-pair-analysis
#10
Arash Momeni, Michael A Lanni, Lawrence S Levin, Stephen J Kovach
INTRODUCTION: The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. PATIENTS AND METHODS: Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2)...
June 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28655388/ultrasound-guided-percutaneous-endovascular-treatment-of-arteriovenous-fistula-graft
#11
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje, Tomaž Ključevšek
BACKGROUND: Ultrasound-guided percutaneous endovascular treatment of arteriovenous fistula (AVF) or graft failure is an alternative to radiologically-guided angioplastic methods. Its main advantages are that it can be used with open or percutaneous access, using no contrast media and no radiation. The aim of this study was to analyze the results of ultrasound-guided endovascular treatment of arteriovenous access failure. MATERIAL AND METHODS: Preoperative ultrasound was used to determine the degree of stenosis and the size of balloon used in angioplasty...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28647193/cryopreserved-venous-allograft-is-an-acceptable-conduit-in-patients-with-current-or-prior-angioaccess-graft-infection
#12
Michael P Harlander-Locke, Peter F Lawrence, Aamna Ali, Esther Bae, James Kohn, Christopher Abularrage, Michael Ricci, Gary W Lemmon, Sotero Peralta, Jeffrey Hsu
OBJECTIVE: The durability of cryopreserved allograft has been previously demonstrated in the setting of infection. The objective of this study was to examine the safety, efficacy, patency, and cost per day of graft patency associated with using cryopreserved allograft (vein and artery) for hemodialysis access in patients with no autogenous tissue for native fistula creation and with arteriovenous graft infection or in patients at high risk for infection. METHODS: Patients implanted with cryopreserved allograft for hemodialysis access between January 2004 and January 2014 were reviewed using a standardized, multi-institutional database that evaluated demographic, comorbidity, procedural, and outcomes data...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28633210/value-of-surgery-for-infective-endocarditis-in-dialysis-patients
#13
Sajjad Raza, Syed T Hussain, Jeevanantham Rajeswaran, Asif Ansari, Matteo Trezzi, Amr Arafat, James Witten, Kirthi Ravichandren, Haris Riaz, Hoda Javadikasgari, Sunil Panwar, Sevag Demirjian, Nabin K Shrestha, Thomas G Fraser, José L Navia, Bruce W Lytle, Eugene H Blackstone, Gösta B Pettersson
OBJECTIVES: To determine the value of surgery for infective endocarditis (IE) in patients on hemodialysis by comparing the nature and invasiveness of endocarditis in hemodialysis and nonhemodialysis patients and their hospital and long-term outcomes, and identifying risk factors for time-related mortality after surgery. METHODS: From January 1997 to January 2013, 144 patients on chronic hemodialysis and 1233 nonhemodialysis patients underwent valve surgery for IE at our institution...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28619645/introduction-of-arteriovenous-grafts-with-graft-insertion-anastomosis-for-hemodialysis-access
#14
Takuya Hatakeyama, Hiroyuki Okamoto, Tatsu Nakazawa, Tatsuya Nonaka, Sei Sasaki, Masanobu Hoshino
OBJECTIVE: An arteriovenous bridging graft is a viable option for patients with compromised arteries or veins because of advanced age or diabetes. Arteriovenous graft with graft insertion anastomosis (AVGI) is the novel technique for graft-vein anastomosis where the prosthesis is inserted into the vein, and the anastomosis is performed on the surface of the prosthesis. This study assessed the short-term and long-term results of AVGI to clarify the efficacy of this technique. METHODS: Between 2010 and 2015, AVGI was performed in graft-vein anastomosis of prosthetic forearm loop access...
June 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28604986/reduction-of-lung-congestion-following-arteriovenous-fistula-flow-reduction-in-renal-graft-recipient
#15
Krzysztof Letachowicz, Oktawia Mazanowska, Maria Boratyńska, Marta Obremska, Anna Goździk, Mariusz Kusztal, Magdalena Krajewska, Tomasz Gołębiowski, Marian Klinger
No abstract text is available yet for this article.
June 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28599902/cost-effectiveness-analysis-of-vascular-access-referral-policies-in-ckd
#16
Steven M Shechter, Talon Chandler, M Reza Skandari, Nadia Zalunardo
BACKGROUND: The optimal timing of vascular access referral for patients with chronic kidney disease who may need hemodialysis (HD) is a pressing question in nephrology. Current referral policies have not been rigorously compared with respect to costs and benefits and do not consider patient-specific factors such as age. STUDY DESIGN: Monte Carlo simulation model. SETTING & POPULATION: Patients with chronic kidney disease, referred to a multidisciplinary kidney clinic in a universal health care system...
June 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28593158/fontan-revision-with-y-graft-in-a-patient-with-unilateral-pulmonary-arteriovenous-malformation
#17
Jeong-Woo Lee, Jeong-Jun Park, Hyun Woo Goo, Jae Kon Ko
The extracardiac conduit Fontan procedure is the last surgical step in the treatment of patients with a functional single ventricle. An acquired pulmonary arteriovenous malformation may appear perioperatively or postoperatively due to an uneven hepatic flow distribution. Here we report a case of a bifurcated Y-graft Fontan operation in a 15-year-old male patient with a unilateral pulmonary arteriovenous malformation after an extracardiac conduit Fontan operation.
June 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28590946/hospitalization-among-individuals-waitlisted-for-kidney-transplant
#18
Kira L Newman, Raymond J Lynch, Andrew B Adams, Rebecca Zhang, Stephen O Pastan, Rachel E Patzer
BACKGROUND: For patients waitlisted for a deceased-donor kidney, hospitalization is associated with a lower likelihood of transplantation and worse posttransplant outcomes. However, individual-, neighborhood-, and regional-level risk factors for hospitalization throughout the waitlist period and specific causes of hospitalization in this population are unknown. METHODS: We used United States Renal Data System Medicare-linked data on patients waitlisted between 2005 and 2013 with continuous enrollment in Medicare Parts A & B (n=53 810) to examine the association between annual hospitalization rate and a variety of demographic, clinical, and social factors...
June 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28579291/successful-use-of-partial-aneurysmectomy-and-repair-approach-for-managing-complications-of-arteriovenous-fistulas-and-grafts
#19
Shouwen Wang, Michele S Wang
OBJECTIVE: Arteriovenous fistulas and grafts may often be associated with localized complications related to aneurysms/pseudoaneurysms, buttonholes, or structural defects that require proper management to ensure continued access functionality for hemodialysis. Partial aneurysmectomy and repair (PAR) is a targeted surgical approach specifically designed for managing these complications. The basic concepts of PAR include resecting unhealthy or excessive tissue over an access, reconstructing the vascular access lumen using in situ vascular wall or tissue when possible, and closing overlying skin with healthy margins to promote reliable healing...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28578897/inadvertent-anastomosis-of-the-left-internal-mammary-artery-to-the-great-cardiac-vein
#20
Shahryar G Saba, John N Makaryus, Shoshanah Kahn, Rakesh Shah, Perwaiz Meraj
We present an uncommon and underreported complication of coronary artery bypass graft surgery: erroneous anastomosis of the left internal mammary artery to the great cardiac vein. The iatrogenic aorto-coronary arteriovenous fistula with left-to-right shunting resulted in dilation of the coronary sinus, a supporting secondary finding. Factors predisposing to this inadvertent anastomosis include an intramyocardial segment of the left anterior descending coronary artery, demonstrated in this case, as well as epicardial fat and potentially fibrosis of the underlying myocardium...
May 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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