Arteriovenous fistulae

For hemodialysis-dependent patients, maintaining functional access is a crucial lifeline. Thrombosed access should be salvaged as soon as possible to avoid complications of missed dialysis and to maximize the chance of success. Due to unfortunate circumstances, this patient's thrombosed arteriovenous fistula was not salvaged for 7 months. Despite the chronicity, endovascular salvage was achieved, with subsequent successful cannulation for maintenance dialysis. Contrary to conventional wisdom, chronically thrombosed arteriovenous fistulas can be salvaged through endovascular means with appropriate patient selection...

This review explores the future role of venous sinus stenting (VSS) in the management of idiopathic intracranial hypertension and pulsatile tinnitus. Despite its favorable safety profile and clinical outcomes compared with traditional treatments, VSS is not yet the standard of care for these conditions, lacking high-level evidence data and guidelines for patient selection and indications. Current and recently completed clinical trials are expected to provide data to support the adoption of VSS as a primary treatment option...

OBJECTIVE: To observe the multi-slice spiral CT angiography (MSCTA) imaging features of arteriovenous fistula dysfunction in patients undergoing maintenance hemodialysis and analyze the significance of the imaging examination. METHODS: Altogether 90 patients with end-stage renal disease treated by maintenance hemodialysis in General Hospital of China Resources & Wisco from June 2020 to February 2023 were divided into a normal function group (n=68) and a dysfunction group (n=22) according to the function of autogenous arteriovenous fistula...

OBJECTIVES: To evaluate the efficacy of rejoining mainstream and accessory veins for forced maturation of autogenous arteriovenous fistula (AVF) METHODS: Twenty-three patients who underwent forced maturation through vein rejoining between January 2018 and September 2022 were included. In cases where AVF maturation failure due to the presence of accessory veins, rejoining was primarily considered when distinguishing the main branch becomes challenging. This difficulty typically occurs when the sizes of the two vessels are nearly equal and the combined diameters of these veins exceed 6 mm...

Coronary artery fistula (CAF) is characterized as a congenital or acquired abnormal communication between a coronary artery and any of the four chambers of the heart (coronary-cameral fistula) or great vessels (coronary arteriovenous fistula) bypassing the capillaries within myocardium. CAF is a rare disease, challenging to diagnose and treat depending on the anatomical location and type of the fistula and accompanying diseases. This study aims to report a case with multiple coronary artery to coronary sinus (CS) fistulas with giant left circumflex artery and multivalvular infective endocarditis...

OBJECTIVES: This review will discuss the use of distal adjuncts for improving graft patency in high risk lower extremity bypasses. METHODS: Factors that contribute to the increased risk of failure in high risk lower extremity bypasses, such as the use of non-autogenous conduits, the creation of bypasses to very distal arterial targets, and bypasses in patients with significant tibial arterial disease, will be discussed. RESULTS: The use of surgical techniques such as creating venous cuffs, venous patches, and arteriovenous fistulas have been shown to improve the patency of high risk bypasses...

BACKGROUND: Although distal native fistula is the best first-line vascular access (VA), upper arm fistula (UAF) prevalence is increasing worldwide, except in Japan. Our previous survey on 50% of hemodialysis patients (HP) revealed a prevalence of UAF of less than 5%, which is lower than the findings published by the DOPPS 5 study in our country. We analyzed the VA prevalence on 100% of HPs from our department. METHODS: In December 2021, we investigated the prevalence of vascular access of 1295 hemodialysis patients from 17 dialysis factories...

BACKGROUND: Dural sinus wall thickness and wall enhancement index (WEI) of dural arteriovenous fistulae (DAVFs) have not been well characterized. This study aimed to measure the sinus wall thickness and WEI by using magnetic resonance vessel wall imaging (MR-VWI). METHODS: A total 27 DAVF patients and 30 normal healthy individuals were enrolled in this study. All participants were scanned by a 3 T MR scanner with the black blood sequence. The wall thickness and the WEI of the great cerebral vein, the intracranial main dural sinuses with DAVFs, and the contralateral sinuses were measured by two independent neuroradiologists...

BACKGROUND: Clinical failure of arteriovenous fistulae (AVF) is frequently due to juxta-anastomotic neointimal hyperplasia (JANIH). Although the mouse AVF model recapitulates human AVF maturation, previous studies focused on the outflow vein distal to the anastomosis. We hypothesized that the juxta-anastomotic area (JAA) has increased NIH compared to the outflow vein. METHOD: AVF were created in C57BL/6 mice without or with chronic kidney disease (CKD). Temporal and spatial changes of the JAA were examined using histology and immunofluorescence...

Introduction Arteriovenous fistulas (AVFs) are the preferred type of vascular access for hemodialysis due to their lower risk of complications. This study aimed to determine the role of Doppler evaluation in assessing AVF. Materials and methods We conducted an 18-month prospective observational study of 33 hemodialysis patients who underwent a procedure for the creation of AVF at the Department of Radio-Diagnosis at Sri Devaraj Urs Academy of Higher Education and Research. Patients were evaluated using color Doppler ultrasound...

OBJECTIVES: After forearm and arm cephalic veins are no longer available as options, the choices of arm vascular access between one-staged brachial-basilic vein transposition (BBAVF) and arm straight arteriovenous graft (AS-AVG) for hemodialysis are controversial. This study aims to compare outcomes between groups. METHODS: All one-staged BBAVF and AS-AVG from August 2014 to December 2019 were reviewed. In cases of suitable basilic vein of 3 mm or more present from cubital crease to axilla, one-staged BBAVF was preferred...

Contained vascular injuries (CVI) of spleen include pseudoaneurysms (PSA) and arterio-venous fistulae (AV-fistulae), and their reported prevalence varies. Our purpose was to assess the prevalence of early splenic CVI seen on admission CT in patients with splenic trauma admitted to a single level 1 trauma center in 2013-2021, and its detection in different CT protocols. A retrospective, single-center longitudinal cohort study. Nine-year data (2013-2021) of all patients with suspected or manifest abdominal trauma were retrieved...

OBJECTIVES: Some studies suggest that regional (RA) provides better patency for arteriovenous fistula (AVF) for hemodialysis (HD) access as compared to Local (LA) and General Anesthesia (GA). This study evaluates the impact of anesthetic modality on long term fistula function at 12 months. METHODS: A retrospective review of patients undergoing cephalic vein-based HD access in consecutive cases between 2014 and 2019 was conducted from five safety net hospitals. The primary endpoint was functional patency at 12 months...

BACKGROUND: Vascular complications are a common occurrence during atrial fibrillation ablation. Observational studies indicate that the utilization of ultrasound (US)-guided puncture may decrease the incidence of vascular complications; however, its routine use is not established in many centres. METHODS: Patients undergoing catheter ablation for atrial fibrillation were included sequentially. All patients receiving US-guided punctures were prospectively enrolled (US group), while patients who underwent the procedure with standard puncture technique served as control group (No-US group)...

Brachial artery pseudoaneurysms are a rare entity, which can occur secondary to infectious, traumatic, or iatrogenic causes. We present a 78-year-old female with end-stage renal disease on hemodialysis via a right brachio-basilic arteriovenous fistula. She had previously undergone numerous fistulograms and endovascular interventions for right upper extremity swelling due to prolonged bleeding following dialysis. After a recent fistulogram she developed recurrent arm swelling. Duplex showed a large hematoma without any evidence of vascular flow...

BACKGROUND: Spinal epidural arteriovenous fistulas (SEDAVFs) are rarely diagnosed vascular malformations that can cause spinal cord compression and congestive myelopathy. METHODS: This is a single-center, retrospective case series of patients with SEDAVFs who underwent observation or treatment at UCLA medical center between 1993 and 2023. RESULTS: Between 1993 and 2023 a total of 26 patients at UCLA were found to have a SEDAVF. The median age at treatment was 59 years (range 4 months to 91 years)...

OBJECTIVES: This study aimed to collect evidence to improve the arteriovenous fistula practice by investigating vascular access routes and by identifying the factors influencing the preferred types of vascular access routes for the first-time hemodialysis in our center. METHODS: We performed an epidemiological, prospective, cohort study. The study included 308 patients, who underwent hemodialysis for the first time between March 2023 and August 2023 in our hemodialysis center...

INTRODUCTION: Paediatric vascular access is a demanding field. The need for a multidisciplinary team is mandatory in children with end-stage kidney disease (ESKD). Central venous catheters (CVCs) remain the preferred option worldwide. Recent emerging data demonstrated the benefits of using arteriovenous fistulas (AVFs) in the paediatric population for long-term vascular access. The small vessel size in children represents a surgical challenge for vascular access. CASE PRESENTATION: We report three cases from our haemodialysis department and the difficulty in maintaining permanent vascular access...

INTRODUCTION: Vascular access surgery (VAS) involves the creation and maintenance of arteriovenous access to facilitate haemodialysis. The prevalence of haemodialysis is rising despite increases in kidney transplants on a yearly basis. There is currently only one access surgery fellowship accredited by the Royal College of Surgeons of England. We aimed to establish the experience and perceived competence in access surgery of senior vascular surgery trainees. METHODS: A short questionnaire (SurveyMonkey) was used to survey all senior (ST6-ST8) vascular surgery trainees in Health Education England (HEE) vascular surgery training programmes...

Arteriovenous fistula (AVF) is the most commonly used vascular access for hemodialysis in patients with end-stage renal disease. Vascular diseases such as atherosclerosis and thrombosis, triggered by altered hemodynamic conditions, are the main causes of access failure. Changes in blood viscosity accelerate access dysfunction by affecting local velocities and wall shear stress (WSS) distribution in the circulation. Numerical simulation was employed to analyze and compare the hemodynamic behavior of AVF under different blood viscosities (0...