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Renal vascular access

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https://www.readbyqxmd.com/read/28937059/the-effect-of-an-educational-program-for-vascular-access-care-on-nurses-knowledge-at-dialysis-centers-in-khartoum-state-sudan
#1
Kalthoum Ibrahim Yousif, Hasan Abu-Aisha, Omar Ibrahim Abboud
End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#2
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28934599/rewarming-after-severe-accidental-hypothermia-using-the-esophageal-heat-transfer-device-a-case-report
#3
Katarina Katja Primožič, Franci Svenšek, Andrej Markota, Andreja Sinkovič
Patients with severe accidental hypothermia require active rewarming. External rewarming may not be successful in severe hypothermia, and use of invasive techniques is limited to regional centers and is associated with vascular access site and other complications. We present a patient with severe accidental hypothermia who was successfuly rewarmed using a novel esophageal heat transfer device. A 55-year-old male (175 cm, 71 kg) was admitted with the first recorded temperature 23.3°C. Rewarming using renal replacement therapy circuit was unsuccessful because of severe hypotension...
September 21, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#4
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28904808/intracardiac-fistula-an-unusual-complication-of-catheter-related-blood-stream-infection
#5
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/28902772/urinary-cxcl10-chemokine-is-associated-with-alloimmune-and-virus-compartment-specific-renal-allograft-inflammation
#6
Julie Ho, Stefan Schaub, Chris Wiebe, Ang Gao, Caroline Wehmeier, Michael T Koller, Hans H Hirsch, Helmut Hopfer, Peter Nickerson, Patricia Hirt-Minkowski
BACKGROUND: Urinary CXCL10 is a promising biomarker for subclinical tubulointerstitial inflammation, but limited data exists regarding its correlation with (micro)vascular inflammation. Furthermore, no study has evaluated whether concomitant serum CXCL10 improves the discrimination for (micro)vascular inflammation. METHODS: We investigated whether serum/urinary CXCL10 reflect subclinical inflammation within different renal compartments. Patients (n=107) with 107 surveillance biopsies were classified as: normal histology (n=47), normal histology with BKV or CMV viremia (n=17), moderate-severe tubulointerstitial inflammation (tubulitis ≥2, n=18), pure microvascular inflammation (n=15), and isolated v lesions (n=10)...
September 12, 2017: Transplantation
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#7
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28887245/a-pulsatile-fresh-frozen-human-cadaver-circulation-model-for-endovascular-training-a-trial-of-face-validity
#8
Craig Nesbitt, Samuel James Tingle, Robin Williams, James McCaslin, Roger Searle, Sebastian Mafeld, Gerard Stansby
OBJECTIVES: Determine the face validity of a pulsatile fresh frozen human cadaver model (PHCM) for training endovascular practitioners. METHODS: 12 endovascular clinicians performed the same two procedures (catheterisation of the left renal artery and left subclavian artery) on PHCM, and Simbionix angiomentor virtual reality simulator (SVR). They were randomised to begin on either the PHCM or SVR. A pre-trial questionnaire determined participants' endovascular experience...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885654/what-is-the-best-setting-for-receiving-dialysis-vascular-access-repair-and-maintenance-services
#9
Audrey M El-Gamil, Al Dobson, Nikolay Manolov, Joan E DaVanzo, Gerald A Beathard, Terry Foust Litchfield, Brook Cowin
INTRODUCTION: Advances in dialysis vascular access (DVA) management have changed where beneficiaries receive this care. The effectiveness, safety, quality, and economy of different care settings have been questioned. This study compares patient outcomes of receiving DVA services in the freestanding office-based center (FOC) to those of the hospital outpatient department (HOPD). It also examines whether outcomes differ for a centrally managed system of FOCs (CMFOC) compared to all other FOCs (AOFOC)...
September 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28874169/transfemoral-versus-transapical-approach-for-transcatheter-aortic-valve-implantation-hospital-outcome-and-risk-factor-analysis
#10
Enrico Ferrari, Eric Eeckhout, Sanjiv Keller, Olivier Muller, Piergiorgio Tozzi, Denis Berdajs, Ludwig Karl von Segesser
BACKGROUND: Transcatheter aortic valve implantation is indicated in high-risk patients with aortic stenosis. We compared the clinical outcome of 180 consecutive patients who underwent transapical (TA) and transfemoral (TF) procedures in a single centre. METHODS: Ninety consecutive TA (TA-group) and 90 consecutive TF (TF-group) were performed from 2009 to 2014. Clinical variables were prospectively collected and retrospectively analysed for hospital outcomes and to identify risk factors for hospital mortality, vascular complications and stroke...
September 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28870431/could-parenchymal-enhancement-on-contrast-enhanced-spectral-mammography-cesm-represent-a-new-breast-cancer-risk-factor-correlation-with-known-radiology-risk-factors
#11
S L Savaridas, D B Taylor, D Gunawardana, M Phillips
AIM: To compare background parenchymal enhancement (BPE) on contrast-enhanced (CE) spectral mammography (CESM) with CE magnetic resonance imaging (MRI), and evaluate how these relate to hormonal status, mammographic breast density (MBD) and MRI fibroglandular tissue volume (FGTV). METHODS AND MATERIALS: Between June 2012 to October 2015, participants in a cancer staging study underwent full-field digital mammography (FFDM), CEMRI, and CESM. Two readers independently rated FGTV, MBD, and BPE using the Breast Imaging-Reporting and Data System (BI-RADS) criteria...
September 1, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28843824/venous-thromboembolism-and-vascular-access-thrombosis-in-patients-with-end-stage-renal-disease-on-maintenance-hemodialysis-cross-sectional-results-of-the-vienna-investigation-of-atrial-fibrillation-and-thromboembolism-in-patients-on-hemodialysis-vivaldi
#12
Oliver Königsbrügge, Matthias Lorenz, Martin Auinger, Sabine Schmaldienst, Renate Klauser-Braun, Josef Kletzmayr, Ella Grilz, Florian Posch, Marlies Antlanger, Ingrid Pabinger, Marcus Säemann, Cihan Ay
BACKGROUND: Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD) are at risk for occurrence of vascular access thrombosis and venous thromboembolism (VTE). Understanding the extent of these complications and identifying risk factors can help improve management strategies. METHODS: Adult HD patients were cross-sectionally recruited into the Vienna InVestigation of AtriaL fibrillation and thromboembolism in patients on hemoDIalysis (VIVALDI)...
August 19, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28822660/prospective-randomized-study-of-long-term-hemodialysis-catheter-removal-versus-guidewire-exchange-to-treat-catheter-related-bloodstream-infection
#13
Hossam M Saleh, Mohamed M Tawfik, Hesham Abouellail
BACKGROUND: Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic antibiotics while keeping the catheter in place is not effective. Among the different modalities of CRBSI management are catheter removal (CR) and guidewire exchange (GE) of the catheter...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822538/smooth-muscle-nitric-oxide-responsiveness-and-clinical-maturation-of-hemodialysis-arteriovenous-fistulae
#14
Xiaoyong Tong, Xiuyun Hou, Christopher Wason, Tal Kopel, Richard A Cohen, Laura M Dember
The arteriovenous fistula is the preferred type of hemodialysis vascular access for patients with end-stage renal disease, but a high proportion of newly created fistulas fail to mature for use. Stenosis caused by neointimal hyperplasia often is present in fistulas with maturation failure, suggesting that local mechanisms controlling vascular smooth muscle cell (SMC) migration and proliferation are important contributors to maturation failure. SMCs cultured from explants of vein tissue obtained at the time of fistula creation from 19 patients with end-stage renal disease were studied to determine whether smooth muscle responsiveness to nitric oxide is associated with fistula maturation outcomes...
September 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28819334/cytokine-signature-in-end-stage-renal-disease-patients-on-hemodialysis
#15
Danyelle Romana Alves Rios, Melina Barros Pinheiro, Wander Valadares de Oliveira Junior, Karina Braga Gomes, Andréa Teixeira Carvalho, Olindo Assis Martins-Filho, Ana Cristina Simões E Silva, Luci Maria Sant'Ana Dusse
Hemodialysis is a modality of blood filtration in which accumulated toxins and water are removed from the body. This treatment is indicated for patients at the end stage of renal disease. Vascular access complications are responsible for 20-25% of all hospitalizations in dialyzed patients. The occurrence of thrombosis in the vascular access is a serious problem that may severely compromise or even make the hemodialysis impossible, which is vital for the patient. The aim of this study was to investigate inflammatory profile in patients undergoing hemodialysis as well as the association between these alterations and vascular access thrombosis...
2017: Disease Markers
https://www.readbyqxmd.com/read/28804237/aneurysmal-degeneration-of-the-brachial-artery-after-vascular-access-creation-surgical-treatment-results
#16
Sérgio Teixeira, Pedro Sá Pinto, Carlos Veiga, Ivone Silva, Rui Almeida
True peripheral artery aneurysms proximal to a longstanding arteriovenous fistula is a well-recognized complication. Late aneurysmal degeneration is rare. This study analyzed the characteristics, therapeutic options, and outcomes of true donor brachial artery aneurysms (DBAA) after arteriovenous fistula (AVF) for hemodialysis. We retrospectively collected the data of patients with DBAA after AVF creation, surgically repaired between January 2001 and September 2015. We excluded patients with pseudoaneurysms, anastomotic aneurysms, and infected aneurysms...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28779787/effect-of-statins-on-survival-in-patients-undergoing-dialysis-access-for-end-stage-renal-disease
#17
Paola De Rango, Basso Parente, Luca Farchioni, Enrico Cieri, Beatrice Fiorucci, Selena Pelliccia, Alessandra Manzone, Gioele Simonte, Massimo Lenti
The benefit of statin therapy in patients with advanced chronic kidney disease remains uncertain. Randomized trials have questioned the efficacy of the drug in improving outcomes for on-dialysis populations, and many patients with end-stage renal disease are not currently taking statins. This study aimed to investigate the impact of statin use on survival of patients with vascular access performed at a vascular center for chronic dialysis. Consecutive end-stage renal disease patients admitted for vascular access surgery in 2006 to 2013 were reviewed...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28779782/future-research-directions-to-improve-fistula-maturation-and-reduce-access-failure
#18
REVIEW
Haidi Hu, Sandeep Patel, Jesse J Hanisch, Jeans M Santana, Takuya Hashimoto, Hualong Bai, Tambudzai Kudze, Trenton R Foster, Jianming Guo, Bogdan Yatsula, Janice Tsui, Alan Dardik
With the increasing prevalence of end-stage renal disease, there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis, but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes in the setting of uremia, systemic inflammation, oxidative stress, and pre-existent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis and development of neointimal hyperplasia that narrows the AVF lumen, typically near the fistula anastomosis...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28779781/vascular-access-should-be-tailored-to-the-patient
#19
REVIEW
Krzysztof Letachowicz, Przemysław Szyber, Tomasz Gołębiowski, Mariusz Kusztal, Waldemar Letachowicz, Wacław Weyde, Jerzy Garcarek, Marian Klinger
A cornerstone of hemodialysis treatment is the creation of a functional and durable dialysis vascular access. Every patient with chronic kidney disease should have a plan of renal replacement therapy and access site protection. Factors having a crucial impact on vascular access selection include age, comorbidity, vessel quality, prognosis, dialysis urgency, and surgeon's preferences. Our medical group have reviewed these factors in our patients and, based on recently published data, developed a clinical decision tree for dialysis access in the chronic kidney disease patient...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777403/long-term-outcome-of-upper-extremity-arteriovenous-fistula-using-pslot-single-center-longitudinal-follow-up-using-a-protocol-based-approach
#20
Michael Darcy, Neeta Vachharajani, Tracy Zhang, Naganathan Mani, Seung Kwon Kim, Sarah Matson, Michaeline Wood, Surendra Shenoy
INTRODUCTION: Functional arteriovenous fistula (AVF) is the best vascular access for end-stage renal disease patients. AVF maturation is variable and many require additional interventions to achieve functionality. Long-term benefits of such interventions are unclear. Using a protocol for AVF planning, creation, maturation evaluation and performing interventions based on objective findings along with maintaining a database on follow-up is necessary to evaluate this question.The aim of this study is to evaluate the long-term outcome of newly constructed AVFs using a protocol-based approach in a tertiary care academic center...
July 29, 2017: Journal of Vascular Access
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