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https://www.readbyqxmd.com/read/28892556/parenteral-anticoagulation-in-ambulatory-patients-with-cancer
#1
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/28879566/success-rate-and-complications-of-sharp-recanalization-for-treatment-of-central-venous-occlusions
#2
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/28868984/the-new-kidney-donor-allocation-system-and-implications-for-anesthesiologists
#3
Srikanth Sridhar, Sara Guzman-Reyes, Sam D Gumbert, Semhar J Ghebremichael, Angelina R Edwards, Mark J Hobeika, Wasim A Dar, Evan G Pivalizza
Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28865977/safety-and-efficacy-of-polyurethane-vascular-grafts-for-early-hemodialysis-access
#4
John D Kakisis, Constantine Antonopoulos, George Mantas, Evaggelos Alexiou, Konstantina Katseni, George Sfyroeras, Konstantinos Moulakakis, George Geroulakos
BACKGROUND: Arteriovenous grafts made of polyurethane (PU) have the advantage of early cannulation obviating the placement of a central vein catheter in patients with an acute need for long-term hemodialysis. The aim of the present study was to evaluate the safety, efficacy and complication rate of PU vascular grafts for dialysis access in patients in whom early cannulation was performed. METHODS: Between January 2007 and December 2015, 125 straight brachial-axillary grafts were placed in patients with an acute thrombosis of a previous arteriovenous access...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28852577/sequential-venous-percutaneous-transluminal-angioplasty-and-balloon-dilatation-of-the-interatrial-septum-during-percutaneous-edge-to-edge-mitral-valve-repair
#5
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28844205/ultrasound-guided-central-venous-catheter-placement-a-structured-review-and-recommendations-for-clinical-practice
#6
REVIEW
Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view...
August 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28839904/uk-practice-in-the-prevention-of-central-venous-catheter-associated-thrombosis-in-adults-on-home-parenteral-nutrition
#7
L Macdougall, J Hanley, C Mountford, N P Thompson
BACKGROUND: Maintaining central access is imperative for the delivery of home parenteral nutrition (HPN) in those with intestinal failure. Methods to reduce central venous catheter infection are well recognised; however, the prevention of line thrombosis is less well studied. METHODS: This paper reviews the current evidence and reports a survey of current practice within the UK. Using an electronic survey, respondents were asked to detail their use of anticoagulation in different patient groups and the type of anticoagulation used...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28827013/unmasking-of-previously-asymptomatic-central-venous-stenosis-following-percutaneous-transluminal-angioplasty-of-hemodialysis-access
#8
Jarrod E Ehrie, Therese E Sammarco, Jesse L Chittams, Scott O Trerotola
PURPOSE: To determine the frequency of new-onset symptoms of central venous stenosis (CVS) after percutaneous transluminal angioplasty (PTA) of a hemodialysis access-related stenosis in patients with previously asymptomatic CVS and to identify risk factors for this phenomenon. MATERIALS AND METHODS: Retrospective review was performed of patients treated with PTA for an access-related stenosis (excluding central vein interventions) between 2001 and 2016 who returned within 3 months with symptoms of CVS (ie, "unmasking"): 39 patients met these criteria...
August 18, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28782257/how-to-perform-extracorporeal-photopheresis-via-port-catheter
#9
Katharina Schwede, Stephanie Nagel, Jan-Christoph Simon, Mirjana Ziemer
BACKGROUND: Extracorporeal photopheresis (ECP) is commonly performed via peripheral venous access catheter. If this is not possible, a tunneled central venous catheter may be considered. However, this access mode may be associated with high complication rates. Port catheters and permanent arteriovenous fistulas in principle could serve as alternative options; however, treatment opinions are limited. STUDY DESIGN AND METHODS: We report on four adult patients with poor peripheral vein conditions in whom we performed ECP via port catheter...
August 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28779785/symptomatic-superior-vena-cava-syndrome-in-hemodialysis-patients-mid-term-results-of-primary-stenting
#10
MULTICENTER STUDY
Mafalda Massara, Giovanni De Caridi, Antonino Alberti, Pietro Volpe, Francesco Spinelli
This clinical report details the results of endovascular treatment of symptomatic superior vena cava syndrome due to central vein stenosis or obstruction (CVSO) by stent angioplasty in patients with dialysis-dependent end-stage renal disease. A 3-year retrospective review of two institutional registries identified 25 chronic hemodialysis patients (17 men, 8 women) affected by CVSO who received endovascular treatment. The majority of the patients (n = 19) presented with symptomatic arm, breast, and facial swelling; and 6 patients presented with dialysis-access dysfunction and venous-line hypertension...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777412/atypical-use-of-picc-in-infants-and-small-children-a-unicentric-experience
#11
Filippo Bernasconi, Clelia Zanaboni, Andrea Dato, Andrea Dolcino, Michela Bevilacqua, Luigi Montagnini, Nicola Disma
INTRODUCTION: The peripherally inserted central catheters (PICCs) are vascular access devices (VAD) that are increasingly being used in the pediatric population. If a small vein caliber prevents positioning the catheter in the arm, the following step is to position the same catheter in the supraclavicular area, which can be defined as an off-label use or "atypical" approach, first described by Pittiruti. MATERIALS AND METHODS: We retrospectively reviewed PICC positioning with puncture-site in the supra-clavicular area ("atypical" PICC insertion) and then tunneled on the chest...
July 29, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28765996/non-central-peripherally-inserted-central-catheters-in-neonatal-intensive-care-complication-rates-and-longevity-of-catheters-relative-to-tip-position
#12
Bernard Goldwasser, Catalina Baia, Mimi Kim, Benjamin H Taragin, Robert M Angert
BACKGROUND: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central position with the tip ending in the superior or inferior vena cava. This is not always achievable, and sometimes the tip remains in a peripheral location. Higher complication rates have been reported with non-central PICCs; however these findings have not been confirmed in a solely neonatal series and PICCs with tips in peripheral veins have not been studied...
August 1, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28752005/ultrasound-guided-cannulation-of-the-brachiocephalic-vein-in-infants-and-children-is-useful-and-stable
#13
Mark E Thompson
OBJECTIVE: Ultrasound-guided (USG) cannulation of the brachiocephalic vein (BCV) has been shown to be technically easy. We hypothesised that adoption of USG in-plane cannulation of the BCV as the primary approach to central venous cannulation at our institution would lead to central venous cannulation for a greater variety of indications. METHODS: We performed retrospective, descriptive comparison of all central lines placed in patients aged <16 years who underwent any surgical operation during calendar years 2012-2014 at a small, free-standing children's hospital...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28731492/factors-causing-loss-of-normal-doppler-waveform-of-the-left-internal-jugular-vein-evaluation-on-chest-computed-tomography
#14
Min Cheol Ku, Myung Gyu Song, Tae-Seok Seo, Eun Young Kang, Hwan Seok Yong, Jae Wook Lee
PURPOSE: To evaluate the presence and causes of left brachiocephalic vein (LBCV) steno-occlusive lesions in patients with loss of normal waveform in Doppler ultrasound of the left internal jugular vein (LIJV). MATERIALS AND METHODS: We performed Doppler ultrasound of both internal jugular veins in 1912 patients who received an implantable venous access port from August 2013 to January 2016. Among them, 106 patients showed loss of normal Doppler waveforms of the LIJV (56 men and 50 women; mean age, 61...
July 19, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#15
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28721474/single-stick-tunneled-central-venous-access-using-the-jugular-veins-in-infants-weighing-less-than-5%C3%A2-kg
#16
Will S Lindquester, C Matthew Hawkins, Eric J Monroe, Anne E Gill, Giridhar M Shivaram, F Glen Seidel, Matthew P Lungren
BACKGROUND: Despite the demonstrated feasibility of the single-stick technique in the femoral vein, its use in neonates and infants for placing central lines in internal and external jugular veins has not been reported. OBJECTIVE: Describe and assess the safety and efficacy of tunneled jugular central venous catheter placement performed under ultrasound (US) and fluoroscopic guidance in neonates and infants weighing <5 kg using the single-stick technique at three tertiary pediatric hospitals...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#17
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28668241/patient-satisfaction-and-experience-with-intravenously-administered-c1-inhibitor-concentrates-in-the-united-states
#18
Marc A Riedl, Aleena Banerji, Paula J Busse, Douglas T Johnston, Mark A Davis-Lorton, Shital Patel, Howard Parr, Joseph Chiao, Douglas J Watson, Earl Burrell, Thomas Machnig
BACKGROUND: Hereditary angioedema (HAE) is a rare genetic disorder with substantial morbidity and mortality. Despite expanded choices for effective acute treatment, prophylactic options are more limited. Intravenous C1 esterase inhibitor (C1-INH[IV]) is licensed and used to prevent HAE symptoms. OBJECTIVE: To better understand patient experiences with using C1-INH(IV), including level of satisfaction and types and frequency of complications. METHODS: Fifty adult members (≥18 years of age) of the US HAE Association who had HAE type I or II completed a self-administered internet survey...
July 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28665466/long-term-clinical-outcomes-of-the-single-incision-technique-for-implantation-of-implantable-venous-access-ports-via-the-axillary-vein
#19
Tae-Seok Seo, Myung Gyu Song, Jun Suk Kim, Chul Won Choi, Jae Hong Seo, Sang Cheul Oh, Eun Joo Kang, Jae-Kwan Lee, Sung-Yong Lee
PURPOSE: To evaluate long-term clinical outcomes and complications of the single-incision technique for implantation of totally implantable venous access ports (TIVAPs) via the axillary vein. MATERIALS AND METHODS: A total of 932 TIVAPs were placed in 927 patients between May 2012 and October 2014 using a single-incision technique. Patients included 620 men and 307 women with a mean age of 60.0 years. TIVAPs were placed via the left (n = 475) and right (n = 457) axillary veins after making a single oblique vertical incision and medial side pocket without subcutaneous tunneling...
July 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28665464/transitioning-from-anatomic-landmarks-to-ultrasound-guided-central-venous-catheterizations-guidelines-applied-to-clinical-practice
#20
Rodrigo Oom, Rui Casaca, Rita Barroca, Sara Carvalhal, Catarina Santos, Nuno Abecasis
INTRODUCTION: Centrally inserted central catheter (CICC) insertion is a commonly performed procedure that may give rise to different complications. Despite the suggestion of guidelines to use ultrasound guidance (USG) for vascular access, not all centers use it systematically. The aim of this study is to illustrate the experience with ultrasound in CICC placement at a high-volume oncological center, in a country where the landmark technique is standard. METHODS: Retrospective analysis of a prospective database was performed on CICC placement under USG in the Central Venous Catheter Unit of Instituto Português de Oncologia de Lisboa Francisco Gentil, from 2012 to 2015...
July 14, 2017: Journal of Vascular Access
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