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Chronic venous access

Federico Nalesso, Francesco Garzotto, Ilaria Petrucci, Sara Samoni, Grazia Maria Virzì, Dario Gregori, Mario Meola, Claudio Ronco
INTRODUCTION: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. MATERIALS AND METHODS: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up...
January 26, 2018: Blood Purification
Tania Huria, Suetonia Palmer, Lutz Beckert, Jonathan Williman, Suzanne Pitama
BACKGROUND: In Aotearoa/New Zealand, Māori, as the indigenous people, experience chronic kidney disease at three times the rate of non-Māori, non-Pacific New Zealanders. Māori commence dialysis treatment for end-stage kidney disease at three times the rate of New Zealand European adults. To examine for evidence of inequity in dialysis-related incidence, treatment practices, and survival according to indigeneity in Aotearoa/New Zealand, utilising a Kaupapa Māori approach. METHODS: We conducted a retrospective cohort study involving adults who commenced treatment for end-stage kidney disease in Aotearoa/New Zealand between 2002 and 2011...
February 20, 2018: International Journal for Equity in Health
Kevin M Baskin, Jeremy C Durack, Kareem Abu-Elmagd, Darcy Doellman, Barbara B Drews, Janna M Journeycake, Samuel A Kocoshis, Gordon McLennan, Stephen M Rupp, Richard B Towbin, Haimanot Wasse, Leonard A Mermel, Seth M Toomay, John C Camillus, Kamran Ahrar, Sarah B White
No abstract text is available yet for this article.
February 15, 2018: Journal of Vascular and Interventional Radiology: JVIR
Sagar Rambhia, Matthew Janko, Robert I Hacker
Central venous occlusion is conventionally managed with balloon angioplasty, stent extension or sharp recanalization. Here we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained two years post-intervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion...
February 15, 2018: Annals of Vascular Surgery
Liliana Simões-Silva, Ricardo Araujo, Manuel Pestana, Isabel Soares-Silva, Benedita Sampaio-Maia
Chronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate...
February 11, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Kristen A Lee, Raja S Ramaswamy
Central venous access has become invaluable in the treatment of patients with a wide array of acute and chronic disease entities. Central venous catheters provide durable, short-term and long-term access solutions while saving the patient from repeated peripheral needle sticks. Central venous catheters include: non-tunneled central venous catheters, tunneled central venous catheters, and port catheters. Typically, the placement of a central venous catheter is performed by Vascular and Interventional Radiologists...
February 2018: Transfusion
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
G Samoila, C P Twine, I M Williams
Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. However, the subclavian vein crosses the first rib anteriorly just behind the manubrium and can also be accessed via an infraclavicular incision. Methods MEDLINE® and Embase™ were searched for all studies on outcomes in patients undergoing infraclavicular first rib resection for treatment of Paget-Schroetter syndrome...
February 2018: Annals of the Royal College of Surgeons of England
Ying Zhang, Xianglei Kong, Lijun Tang, Yong Wei, Dongmei Xu
Arteriovenous fistula is the preferred option for vascular access in hemodialysis patients. The aim of this study was to assess different follow-up methods for hemodialysis patients in our hemodialysis center in China. A cohort of 124 patients with stage 3 chronic kidney disease was recruited and double-blind randomly assigned into two groups. Patients in Group A received phone calls to schedule their next consultation a week in advance. Patients in Group B scheduled their next appointment at the end of each visit...
January 19, 2018: Therapeutic Apheresis and Dialysis
Young Erben, Haraldur Bjarnason, Gudrun L Oladottir, Robert D McBane, Peter Gloviczki
OBJECTIVE: The aim of this study was to evaluate outcomes of endovascular recanalization of the inferior vena cava (IVC) and iliac veins with long-standing chronic venous obstruction caused by nonmalignant disease. METHODS: Medical records for 66 patients who underwent endovascular recanalization of the IVC with or without iliac veins from January 2001 to December 2014 at our medical center were retrospectively reviewed. Primary outcomes included morbidity and mortality; secondary outcomes included primary, primary assisted, and secondary patency and resolution of symptoms...
January 11, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Elizabeth Spiwak, Chad Wiesenauer, Arun Panigrahi, Ashok Raj
Central vein thrombosis as a cause of chylothorax is uncommon, and in a few cases in the literature was related to thrombotic complications of central venous access devices (CVAD). Superior vena cava (SVC) occlusion-induced chylothorax has been described in adult sickle cell disease (SCD) in a setting of chronic indwelling CVAD. There are limited reports on chylothorax induced by central venous thrombosis secondary to chronic CVAD in children with SCD. We describe an 8-year-old male patient, with a history of SCD, maintained on long term erythrocytapheresis for primary prevention of stroke, and whose clinical course was complicated by chylothorax which was successfully treated with a pleuroperitoneal shunt...
January 2, 2018: Children
Peter J Pappas, Sanjiv Lakhanpal, Khanh Q Nguyen, Rohan Vanjara
BACKGROUND: Chronic venous disorders (CVDs) have been estimated to affect up to 20 million Americans. Despite this huge prevalence, the signs, symptoms, and treatment outcomes in patients 65 years of age and older are not well defined. Our goal was to determine the presentation and treatment outcomes in elderly patients compared with a cohort of patients younger than 65 years. METHODS: From January 2015 to December 2016, we retrospectively reviewed prospectively collected data from 38,750 patients with CVD from the Center for Vein Restoration's electronic medical record (NextGen Healthcare Information Systems, Irvine, Calif)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Wen-Yi Li, Yi-Cheng Wang, Shang-Jyh Hwang, Shih-Hua Lin, Kwan-Dun Wu, Yung-Ming Chen
BACKGROUND: The clinical consequences of starting chronic peritoneal dialysis (PD) after emergent dialysis via a temporary hemodialysis (HD) catheter has rarely been evaluated within a full spectrum of treated end-stage renal disease (ESRD). We investigated the longer-term outcomes of patients undergoing emergent-start PD in comparison with that of other practices of PD or HD in a prospective cohort of new-onset ESRD. METHODS: This was a 2-year prospective observational study...
December 11, 2017: BMC Nephrology
Mallika L Mendu, Megan F May, Arnaud D Kaze, Dionne A Graham, Salena Cui, Margaret E Chen, Naomi Shin, Ayal A Aizer, Sushrut S Waikar
BACKGROUND: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high morbidity, mortality and resource utilization. The type of vascular access placed for AKI-RRT is an important decision, for which there is a lack of evidence-based guidelines. METHODS: We conducted a prospective cohort study over a 16-month period with 154 patients initiated on AKI-RRT via either a non-tunneled dialysis catheter (NTDC) or a tunneled dialysis catheter (TDC) at an academic hospital...
December 4, 2017: BMC Nephrology
Olivier A Witte, Ahmet Adiyaman, Marnix W van Bemmel, Jaap Jan J Smit, Abdul Ghani, Anand R Ramdat Misier, Arif Elvan, Peter Paul H M Delnoy
INTRODUCTION: Chronic venous occlusion hampers lead revisions and upgrades in patients with a cardiac implantable electronic devices (CIEDs). This can make cardiothoracic surgery, venoplasty, or contra-lateral implantation of leads with tunneling necessary. A technique using venous recanalization may be a preferred alternative. We assessed the efficacy and safety of this new technique. METHODS AND RESULTS: From 2009 to 2016, all consecutive patients planned for lead revision or upgrade with known chronic venous occlusion were studied...
February 2018: Journal of Cardiovascular Electrophysiology
Chance S Dumaine, Robert S Brown, Jennifer M MacRae, Matthew J Oliver, Pietro Ravani, Robert R Quinn
Since the publication of the first vascular access clinical practice guidelines in 1997, the global nephrology community has dedicated significant time and resources toward increasing the prevalence of arteriovenous fistulas and decreasing the prevalence of central venous catheters for hemodialysis. These efforts have been bolstered by observational studies showing an association between catheter use and increased patient morbidity and mortality. To date, however, no randomized comparisons of the outcomes of different forms of vascular access have been conducted...
January 2018: Seminars in Dialysis
Ricardo Cintra Sesso, Antonio Alberto Lopes, Fernando Saldanha Thomé, Jocemir Ronaldo Lugon, Carmen Tzanno Martins
INTRODUCTION: National chronic dialysis data are important for the treatment planning. OBJECTIVE: To report data of the annual survey of the Brazilian Society of Nephrology about chronic kidney disease patients on dialysis in July 2016. METHODS: A survey based on data of dialysis centers from the whole country. The data collection was performed by using a questionnaire filled out on-line by the dialysis centers. RESULTS: 309 (41%) of the dialysis units in the country answered the questionnaire...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Gaetano Alfano, Francesco Fontana, Mario Iannaccone, Patrizia Noussan, Gianni Cappelli
Native arteriovenous fistula (AVF) is the favorite access for hemodialysis (HD). The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) recommends its creation in most patients with renal failure. Unfortunately, intensive efforts to promote native AVF in patients with marginal vessels have increased the rate of primary fistula failure. A non-functioning fistula prompts the use of central venous catheter (CVC) that, unlike AVF, has been associated with an increased risk of morbidity and mortality among patients receiving HD...
November 17, 2017: Journal of Vascular Access
Martyn Dibb, Simon Lal
Patients with chronic intestinal failure are dependent on parenteral nutrition (PN) to maintain health and preserve life. Maintaining safe vascular access is vital to prevent life-threatening complications such as catheter-related bloodstream infection or central venous occlusion. Dedicated central venous catheters with rigorous catheter care aseptic protocols are vital in obtaining good long-term outcomes that allow continuation of PN over many years. Good catheter care requires an experienced multidisciplinary team using appropriate vascular devices, trained to identify and aggressively treat catheter-related bloodstream infections, catheter occlusions, and catheter-related thrombosis...
December 2017: Nutrition in Clinical Practice
Muhammad Mujeeb Zubair, Matthew E Bennett, Eric K Peden
INTRODUCTION: Central venous occlusive (CVO) disease involving the superior vena cava (SVC) and inferior vena cava (IVC) can occur frequently in patients with end-stage renal disease (ESRD) on chronic dialysis. Dialysis access is essential for the survival of these patients. CASE DESCRIPTION: We report a case of a chest wall graft creation using bovine carotid artery conduit in a patient who was experiencing life-threatening loss of dialysis access secondary to her SVC and IVC occlusion along with a hypercoagulable state...
October 3, 2017: Journal of Vascular Access
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