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https://www.readbyqxmd.com/read/28930719/vascular-access-placement-order-and-outcomes-in-hemodialysis-patients-a-longitudinal-study
#1
Mariana Murea, W Mark Brown, Jasmin Divers, Shahriar Moossavi, Todd W Robinson, Benjamin Bagwell, John M Burkart, Barry I Freedman
BACKGROUND: Arteriovenous accesses (AVA) in patients performing hemodialysis (HD) are labeled "permanent" for AV fistulas (AVF) or grafts (AVG) and "temporary" for tunneled central venous catheters (TCVC). Durability and outcomes of permanent vascular accesses based on the sequence in which they were placed or used receives little attention. This study analyzed longitudinal transitions between TCVC-based and AVA-based HD outcomes according to the order of placement. METHODS: All 391 patients initiating chronic HD via a TCVC between 2012 and 2013 at 12 outpatient academic dialysis units were included in this study...
September 21, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#2
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28914866/-extended-endoscopic-endonasal-posterior-transclival-approach-to-tumors-of-the-clival-region-and-ventral-posterior-cranial-fossa-part-1-topographic-and-anatomical-features-of-the-clivus-and-adjacent-structures
#3
A N Shkarubo, K V Koval', G F Dobrovol'skiy, M A Shkarubo, V V Karnaukhov, B A Kadashev, D N Andreev, I V Chernov, O A Gadzhieva, O Yu Aleshkina, E A Anisimova, P L Kalinin, M A Kutin, D V Fomichev, O I Sharipov, D B Ismailov, E S Selivanov
OBJECTIVE: to describe the main topographic and anatomical features of the clival region and its adjacent structures for improvement and optimization of the extended endoscopic endonasal posterior (transclival) approach for resection of tumors of the clival region and ventral posterior cranial fossa. MATERIAL AND METHODS: We performed a craniometric study of 125 human skulls and a topographic anatomical study of heads of 25 cadavers, the arterial and venous bed of which was stained with colored silicone (the staining technique was developed by the authors) to visualize bed features and individual variability...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28912977/isolated-persistent-left-superior-vena-cava-sick-sinus-syndrome-and-challenging-pacemaker-implantation
#4
Hatice S Kemal, Aziz Gunsel, Levent Cerit, Murat Kocaoglu, Hamza Duygu
Persistent left superior vena cava with absent right superior vena cava is a very rare venous anomaly and is known as isolated PLSVC. It is usually an asymptomatic anomaly and is mostly detected during difficult central venous access or pacemaker implantation, though it could also be associated with an increased incidence of congenital heart disease, arrhythmias, and conduction disturbances. Herein, we describe a dual-chamber pacemaker implantation in a patient with isolated PLSVC and sick sinus syndrome.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28912005/proximal-radial-artery-arteriovenous-fistula-for-hemodialysis-vascular-access
#5
William C Jennings, Alexandros Mallios, Nasir Mushtaq
OBJECTIVE: This study reviewed our experience with proximal radial artery-based arteriovenous fistulas (PRA-AVFs) for hemodialysis vascular access, evaluating characteristics of the patients, functional patency, risk of steal syndrome, survival of the patient, and technical considerations. METHODS: We retrospectively analyzed our database of consecutive patients, identifying those individuals with a PRA-AVF created during a 12-year period. In addition to physical examination, all patients underwent ultrasound vessel mapping by the operating surgeon, identifying the PRA-AVF configuration and outflow target most likely to succeed...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28905099/port-implantation-in-patients-with-severe-thrombocytopenia-is-safe-with-interventional-radiology
#6
Annika R Keulers, Lilian Kiesow, Andreas H Mahnken
PURPOSE: Platelet counts <50/nl are often considered a contraindication for surgical and interventional radiology procedures. Yet, there are patients requiring totally implantable venous access ports (TIVAP) in whom normalization of the coagulation state is not feasible. This retrospective study evaluates the safety of interventional radiological TIVAP implantation in patients with severe thrombocytopenia. MATERIALS AND METHODS: From 12/2010 to 12/2014, a total 1200 consecutive radiological TIVAP implantations were performed and retrospectively analyzed...
September 13, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28904808/intracardiac-fistula-an-unusual-complication-of-catheter-related-blood-stream-infection
#7
Abhilash Koratala, Hussain Aboud, Robert Gibson, Karen K Hamilton
In end stage renal disease patients on dialysis, the use of catheter as a vascular access is associated with a significant risk of sepsis compared to an arterio-venous fistula. Our case emphasizes the importance of having high index of suspicion for unusual complications in patients presenting with possible catheter-related blood stream infection and early use of complementary tools such as trans-oesophageal echocardiography whenever applicable.
September 2017: JRSM Open
https://www.readbyqxmd.com/read/28904485/temporary-left-ventricular-pacing-a-desperate-life-saving-measure-in-emergency-situation
#8
Ajaz Ahamad Lone, Mohd Iqbal Dar, Fayaz Ahamad Rather, Mohd Sultan Alai, Imran Hafiz, Jahangir Rashid Beigh
Transcutaneous or transvenous pacing of the right ventricle is performed as a routine practice for patients received with symptomatic bradycardia or complete heart block with relative ease in cath lab. However, more and more patients are received with multiple comorbidities, critical condition, and difficult vascular access. In this article, we describe a patient with difficult venous access with tricuspid regurgitation and displaced the right ventricular pacemaker temporary lead undergoing coronary angiography who was managed with emergent nonconventional left ventricular pacing...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28899228/intraoperative-venoplasty-to-facilitate-placement-of-tunneled-catheters-for-hemodialysis
#9
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective With the implementation of the K-DOQI guidelines, more patients are in need of long-term dialysis catheters until maturation of the arteriovenous fistula. However, on occasion, when placing a tunneled cuffed catheter for hemodialysis, we have encountered difficulty with passing the guidewire in spite of demonstration of a patent cervical portion of the internal jugular vein on duplex. Herein, we review our experience with intraoperative venoplasty for placement of Tesio™ catheters (Medcomp Harleysville, PA)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#10
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28893152/a-new-percutaneous-technique-n-butyl-cyanoacrylate-adhesive-for-the-treatment-of-giant-saphenous-vein-insufficiency
#11
Mehmet Senel Bademci, Kaptanıderya Tayfur, Gökhan Ocakoglu, Serkan Yazman, Muhammet Akyüz, Haydar Yasa
Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28892556/parenteral-anticoagulation-in-ambulatory-patients-with-cancer
#12
REVIEW
Elie A Akl, Lara A Kahale, Maram B Hakoum, Charbel F Matar, Francesca Sperati, Maddalena Barba, Victor E D Yosuico, Irene Terrenato, Anneliese Synnot, Holger Schünemann
BACKGROUND: Anticoagulation may improve survival in patients with cancer through a speculated anti-tumour effect, in addition to the antithrombotic effect, although may increase the risk of bleeding. OBJECTIVES: To evaluate the efficacy and safety of parenteral anticoagulants in ambulatory patients with cancer who, typically, are undergoing chemotherapy, hormonal therapy, immunotherapy or radiotherapy, but otherwise have no standard therapeutic or prophylactic indication for anticoagulation...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28887929/vascular-complications-in-extracoporeal-membrane-oxygenation
#13
REVIEW
Kathleen M Lamb, Hitoshi Hirose
Venoarterial extracorporeal membrane oxygenation is a rescue therapy in patients with severe cardiopulmonary failure. Often, cannulation is done emergently and the femoral vessels are most readily accessible for venous and arterial access. Unfortunately, complications with arterial femoral access can lead to devastating complications, primarily related to limb ischemia. A coordinated protocol of diligent limb examination by trained intensive care unit staff, near infrared spectroscopy monitoring of limbs, and placement of a distal perfusion catheter at the time of femoral cannulation or when signs of ischemia develop, can lead to successful limb salvage...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28887265/modified-staple-aneurysmorrhaphy-for-treating-arteriovenous-fistula-related-venous-aneurysms
#14
R Moskowitz, E Fakhoury, K James
Autogenous arteriovenous fistulas (AVF) are the preferred access for hemodialysis. AVF occasionally develop venous aneurysms and we report a modified staple aneurysmorrhaphy technique for treatment. Briefly, the lateral wall of the venous aneurysm is dissected and a longitudinal staple resection performed. Adjunct procedures include inflow banding and outflow venous angioplasty with possible stenting. In this initial experience, 20 aneurysms were resected in 17 patients. The average AVF age at time of repair was 5...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885213/presentation-of-a-variation-of-the-chorioallantoic-membrane-set-up-as-a-potential-model-for-individual-therapy-for-squamous-cell-carcinoma-of-the-oropharynx
#15
P Kauffmann, M Troeltzsch, R Cordesmeyer, P I Heidekrueger, H Schliephake, M Canis, H A Wolff, M Rave-Fraenk, P Stroebel, A Kehrer, L Prantl, T Aung
The chorioallantoic membrane of fertilized chicken eggs in an early phase of breeding presents an approved test situation for the growth and treatment of human cancer cells.These models work due to the inoculation of cells into the membrane that stays within the egg shell during the time of investigation. In this study a modification of this model is presented. Samples of native tumors, rather than cell lines, are transplanted into the membrane and the body of the egg is taken out of the shell and placed in a plastic bowl...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28883293/usefulness-of-a-peripherally-inserted-central-catheter-for-total-parenteral-nutrition-in-patients-with-inflammatory-bowel-disease
#16
Hirofumi Chiba, Katsuya Endo, Yasuhiro Izumiyama, Takeru Nakano, Daisuke Okamoto, Ryo Ichikawa, Hiroshi Nagai, Shin Matsumoto, Naonobu Yokoyama, Katsutoshi Yamamoto, Yusuke Shimoyama, Takeo Naito, Motoyuki Onodera, Jun Kusaka, Keiichiro Hiramoto, Masatake Kuroha, Yoshitake Kanazawa, Tomoya Kimura, Yoichi Kakuta, Yoshitaka Kinouchi, Tooru Shimosegawa
BACKGROUNDS AND AIMS: Peripherally inserted central catheters (PICC) have been widely used as a blood access route for total parenteral nutrition (TPN) in recent years. However, there have been few reports that evaluated the usefulness of PICC for patients with inflammatory bowel disease (IBD). In this study, we compared the clinical courses in patients with IBD who received TPN during their hospitalization by conventional central venous catheters (CVC) and PICC. PATIENTS AND METHODS: A total of 137 IBD patients were enrolled...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28882115/caught-in-a-no-win-situation-discussions-about-ccsvi-between-persons-with-multiple-sclerosis-and-their-neurologists-a-qualitative-study
#17
S Michelle Driedger, Ryan Maier, Ruth Ann Marrie, Melissa Brouwers
BACKGROUND: In recent years, shared decision making (SDM) has been promoted as a model to guide interactions between persons with MS and their neurologists to reach mutually satisfying decisions about disease management - generally about deciding treatment courses of prevailing disease modifying therapies. In 2009, Dr. Paolo Zamboni introduced the world to his hypothesis of Chronic Cerebrospinal Venous Insufficiency (CCSVI) as a cause of MS and proposed venous angioplasty ('liberation therapy') as a potential therapy...
September 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28881348/accelerating-topical-anaesthesia-using-microneedles
#18
Lleucu B Davies, Christopher Gateley, Phillip Holland, Siôn A Coulman, James C Birchall
BACKGROUND/AIMS: Topical anaesthetics reduce pain during venous access procedures in children. However, clinical use is hindered by a significant anaesthetic onset time. Restricted diffusion of the topical anaesthetic through the stratum corneum barrier is the principal reason for the delayed onset. Microneedles can painlessly pierce the skin. This study evaluated microneedle pre-treatment of ex vivo human skin as a means to increase the rate of tetracaine permeation, in order to accelerate the onset of anaesthesia...
September 8, 2017: Skin Pharmacology and Physiology
https://www.readbyqxmd.com/read/28879566/success-rate-and-complications-of-sharp-recanalization-for-treatment-of-central-venous-occlusions
#19
Emil I Cohen, Christopher Beck, Jesse Garcia, Ryan Muller, Hyun J Bang, Keith M Horton, Farris Hakki
PURPOSE: To evaluate success and safety of needle (sharp) recanalization as a method to re-establish access in patients with chronic central venous occlusions. MATERIALS AND METHODS: Thirty-nine consecutive patients who underwent this procedure were retrospectively reviewed to establish success rate and associated complications. In all cases, a 21- or 22-gauge needle was used to restore connection between two chronically occluded segments after conventional wire and catheter techniques had failed...
September 6, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28879526/intracardiac-echocardiography-for-structural-heart-and-electrophysiological-interventions
#20
REVIEW
Craig Basman, Yuvrajsinh J Parmar, Itzhak Kronzon
PURPOSE OF REVIEW: With an increasing number of interventional procedures performed for structural heart disease and cardiac arrhythmias each year, echocardiographic guidance is necessary for safe and efficient results. The purpose of this review article is to overview the principles of intracardiac echocardiography (ICE) and describes the peri-interventional role of ICE in a variety of structural heart disease and electrophysiological interventions. RECENT FINDINGS: Both transthoracic (TTE) and transesophageal echocardiography have limitations...
September 6, 2017: Current Cardiology Reports
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