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https://www.readbyqxmd.com/read/27911463/vascular-access-types-in-patients-starting-hemodialysis-after-failed-kidney-transplant-does-close-nephrology-follow-up-matter
#1
Naveed Ul Haq, Mohamed Said Abdelsalam, Mohammed Mahdi Althaf, Abdulrahman Ali Khormi, Hassan Al Harbi, Bader Alshamsan, Mamdouh Nasser Albaqumi, Dieter Clemens Broering, Lutfi Alkorbi, Hassan Ali Aleid
BACKGROUND: Native arteriovenous fistulae (AVFs) are preferred while central venous catheters (CVCs) are least suitable vascular access (VA) in patients requiring hemodialysis (HD). Unfortunately, around 80% of patients start HD with CVCs. Late referral to nephrologist is thought to be a factor responsible for this. We retrospectively analyzed the types of VA at HD initiation in renal transplant recipients followed by nephrologists with failed transplant. If early referral to nephrologist improves AVF use, these patients should have higher prevalence of AVF at HD initiation...
November 28, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27911460/retrospective-comparison-of-two-different-approaches-for-ultrasound-guided-internal-jugular-vein-cannulation-in-hemodialysis-patients
#2
Antonio Treglia, Dario Musone, Francesco Amoroso
BACKGROUND: Prevalent hemodialysis patients with vascular access consisting of a central venous catheter (CVC) are continuously increasing over the years. Improvement in evolution and CVC placement procedures represents therefore an essential tool to enhance performance and reduce intraoperative and long-term CVC complications. Internal jugular vein (IJV) catheterization techniques are different according to ultrasound probe position in relation to vein axis and to needle direction in relation to ultrasound beam...
December 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27904815/pneumorrhachis-resulting-in-transient-paresis-after-picc-line-insertion-into-the-ascending-lumbar-vein
#3
Russell Payne, Emily P Sieg, Arabinda Choudhary, Mark Iantosca
Obtaining intravascular access in the neonatal intensive care unit (NICU) is not only critical but also technically challenging. Malposition of the catheter tip is a known and well-documented complication. Specifically, peripherally inserted central venous catheter (PICC) line insertion into the ascending lumbar vein can lead to neurological dysfunction and, in some cases, even death. We present the first reported case of pneumorrhachis (PR) following PICC line insertion into the ascending lumbar vein. Our patient presented with lower extremity weakness and imaging confirmed the presence of air within the spinal canal...
October 17, 2016: Curēus
https://www.readbyqxmd.com/read/27895880/comparison-of-open-cell-stent-and-closed-cell-stent-for-treatment-of-central-vein-stenosis-or-occlusion-in-hemodialysis-patients
#4
Chae Hoon Kang, Seung Boo Yang, Woong Hee Lee, Jae Hong Ahn, Dong Erk Goo, Nae Jin Han, Joon Young Ohm
BACKGROUND: Central vein stenosis or occlusion is a common complication that can lead to significant morbidity and dysfunction of access in the hemodialysis patient. More lesions can develop over time, and preserving access becomes a challenge as life expectancy of the hemodialysis patient increases. OBJECTIVES: The goal was to compare long-term results and determine the outcomes of open-cell stent versus closed-cell stent for central vein stenosis or occlusion in hemodialysis patients...
October 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27893623/efficacy-and-safety-of-intravitreal-conbercept-injections-in-macular-edema-secondary-to-retinal-vein-occlusion
#5
Zuhua Sun, Haiying Zhou, Bing Lin, Xuan Jiao, Yingdong Luo, Feng Zhang, Shanshan Tao, Quan Wu, Zunhong Ke, Xiaoling Liu
PURPOSE: To assess the efficacy and safety of intravitreal conbercept injections in patients with macular edema secondary to retinal vein occlusion (RVO). METHODS: A prospective, Phase II clinical trial was performed on 60 patients with macular edema secondary to RVO. Thirty patients had branch RVO (BRVO) and 30 had central RVO (CRVO). Each patient received intravitreal injections of conbercept monthly up to 3 months, followed by monthly evaluation and injection pro re nata to Month 9...
November 23, 2016: Retina
https://www.readbyqxmd.com/read/27886366/utility-of-blind-percutaneous-jugular-venous-cannulation-in-resource-limited-settings
#6
Opeyemi Komolafe, Olalekan Olatise
BACKGROUND: For the nephrologist practicing in resource-limited settings, vascular ultrasound is often unavailable; consequently, blind percutaneous puncture of large veins is often employed to establish vascular access for hemodialysis. METHODS: To examine the efficacy and safety of this approach we evaluated 53 consecutive patients in whom central vascular access was required. The vascular access route utilized was primarily the right internal jugular vein. In the majority of cases, the indication for central vascular access was hemodialysis...
November 14, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27886362/balloon-assisted-venous-access-salvage-through-a-thrombosed-arteriovenous-graft
#7
Chen Pong Wong, Karthikeyan Damodharan, Thijs A J Urlings, Sivanathan Chandramohan
INTRODUCTION: Maintaining vascular access by means of radiological intervention has become the mainstay of management of patients with central venous stenoses and occlusions (CVO), which can be challenging. We present a case of balloon-assisted percutaneous puncture of an occluded left subclavian vein, through a thrombosed arteriovenous graft, for a tunneled dialysis catheter insertion. METHODS: A thrombosed left arm arteriovenous graft was accessed, and the occluded left subclavian vein was traversed with 0...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27878131/extra-luminal-entrapment-of-guide-wire-a-rare-complication-of-central-venous-catheter-placement-in-right-internal-jugular-vein
#8
Md Abu Masud Ansari, Naveen Kumar, Shailesh Kumar, Sarita Kumari
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27871596/confirmation-of-optimal-guidewire-length-for-central-venous-catheter-placement-using-transesophageal-echocardiography
#9
Manabu Yoshimura, Toshiyuki Nakanishi, Seishi Sakamoto, Takashi Toriumi
STUDY OBJECTIVE: Several authors have reported rare, but severe, complications associated with the length of the intravascular guidewire during central venous catheter placement, as the wire tip can cause cardiac arrhythmia or perforation or become trapped within the vessel. Although one report investigated the optimal guidewire length using fluoroscopy, few reports have precisely measured guidewire position using transesophageal echocardiography (TEE). Here, we investigated the appropriate intravascular length of a guidewire for right internal jugular vein approach using TEE during cardiac surgery...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869288/infraclavicular-access-to-the-axillary-vein-new-possibilities-for-the-catheterization-of-the-central-veins-in-the-intensive-care-unit
#10
Ryszard Gawda, Tomasz Czarnik, Lidia Łysenko
Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27868336/vascular-imaging-for-hemodialysis-vascular-access-planning
#11
Rita L McGill, Robin Ruthazer, Eduardo Lacson, Klemens B Meyer, Dana C Miskulin, Daniel E Weiner
Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010-2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time-dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#12
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27866375/pre-operative-assessment-for-arteriovenous-fistula-placement-for-dialysis
#13
REVIEW
Maria G Marques, Pedro Ponce
Native AV fistulas are considered to be the best VA for most dialysis patients. A careful preoperative process of care is essential to maximize the proportion of fistulas that achieve adequacy for dialysis. An individualized and timely evaluation of patients starts early with the identification of risk factors, followed by a physical examination which should be complemented by ultrasound vascular mapping in most cases. Vascular mapping includes any technique that leads to information on patient's inflow and outflow anatomy (± hemodynamics) as they relate to arteriovenous access creation and may predict maturation...
November 20, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27829522/the-changing-profile-of-safe-techniques-for-the-insertion-of-a-central-venous-catheter-in-pediatric-patients-improvement-in-the-outcome-with-the-experiences-of-500-insertions-in-a-single-institution
#14
Tatsuru Kaji, Takafumi Kawano, Waka Yamada, Koji Yamada, Shun Onishi, Kazuhiko Nakame, Motoi Mukai, Satoshi Ieiri, Hideo Takamatsu
BACKGROUND: The ability to safely insert a central venous catheter (CVC) is critical to avoid associated complications. The aim of this study was to explore appropriate technique to maintain the safety of pediatric patients during CVC. METHODS: We reviewed the surgical records of CVC insertion techniques and associated complications of 503 tunneled CVC insertions performed from 2000 to 2015. RESULTS: Two hundred thirty CVCs (45.7%) were inserted into the subclavian vein using the landmark technique for 10years (first period)...
September 16, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27781373/home-hemodialysis-associated-infection-the-achilles-heel-of-intensive-hemodialysis
#15
REVIEW
Clara K Poon, Christopher T Chan
Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection...
October 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27780607/ultrasound-guided-deep-arm-veins-insertion-of-long-peripheral-catheters-in-patients-with-difficult-venous-access-after-cardiac-surgery
#16
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
OBJECTIVES: To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance. BACKGROUND: In difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters. METHODS: Prospective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed...
October 22, 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27768210/fracture-of-totally-implanted-central-venous-access-devices-a-propensity-score-matched-comparison-of-risks-for-groshong-silicone-versus-polyurethane-catheters
#17
Soichi Kojima, Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui, Toshiharu Mitsuhashi, Susumu Kanazawa
PURPOSE: To evaluate retrospectively the fracture risk of totally implanted venous access devices connected to Groshong silicone (SC) versus polyurethane (PU) catheters, inserted via the internal jugular vein. MATERIALS AND METHODS: The study population comprised 384 SC and 221 PU central venous catheters implanted via the internal jugular vein. The presence of catheter fracture was evaluated. Variables possibly related to catheter fracture were evaluated. First, in order to determine the factors associated with fracture, fracture rates were compared with the log-rank test between the two groups divided by each of the variables...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27759558/a-novel-technique-of-subclavian-artery-cannulation-for-venoarterial-extracorporeal-membrane-oxygenation
#18
Umit Kervan, Sinan Sabit Kocabeyoglu, Dogan Emre Sert, Emre Aygün, Kemal Kavasoglu, Mehmet Karahan, Ertekin Utku Unal, Mustafa Pac
OBJECTIVES: The common femoral artery is the standard site for immediate vascular access when initiating adult venoarterial extracorporeal membrane oxygenation. However, this approach is fraught with problems such as femoral artery occlusion, distal limb ischemia, reperfusion injury resulting in compartment syndrome, retroperitoneal hemorrhage, thrombosis, embolization, and most importantly, pulmonary edema. Here, we show our preference of using the subclavian artery with a side graft as a different cannulation technique for outflow of extracorporeal membrane oxygenation, which can avoid complications associated with different access techniques...
October 14, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27757189/diagnostic-value-of-computerized-tomography-venography-in-detecting-stenosis-and-occlusion-of-subclavian-vein-and-superior-vena-in-chronic-renal-failure-patients
#19
Banafsheh Bakhshoude, Hassan Ravari, Gholam Hosein Kazemzadeh, Masoud Pezeshki Rad
INTRODUCTION: Currently, venography is the standard diagnostic method to examine veins before implementing access, which is invasive in nature. Computerized tomography venography (CTV) can simultaneously indicate deep and superficial venous systems in the upper extremity and their relation to the surrounding anatomical structures; however, its diagnostic value in the detection of central venous disease has yet to be defined. The aim of this study was to determine the diagnostic value of CT venography compared to venography in the diagnosis of stenosis and the occlusion of subclavian veins and the superior vena in renal failure patients...
August 2016: Electronic Physician
https://www.readbyqxmd.com/read/27743808/arteriovenous-fistula-combined-with-brachial-artery-superficialization-is-effective-in-patients-with-a-high-risk-of-maturation-failure
#20
Masaaki Murakami, Genichi Sakaguchi, Noriko Mori
OBJECTIVE: In patients with a high risk of fistula immaturity, we created arteriovenous fistulas (AVFs) combined with brachial artery superficialization. With this procedure, the superficialized arteries are used as drawing routes and the AVFs as returning routes. This is a technical report about AVFs combined with brachial artery superficialization. METHODS: Twenty-four consecutive patients with a high risk of fistula immaturity who underwent AVFs with brachial artery superficialization were included in this single-center retrospective study...
October 12, 2016: Journal of Vascular Surgery
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