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vascular access site complication

J M Madrid Pérez, P M García Barquín, A J Villanueva Marcos, J I García Bolao, G Bastarrika Alemañ
OBJECTIVE: Radiofrequency ablation is an efficacious alternative in patients with symptomatic atrial fibrillation who do not respond to or are intolerant to at least one class I or class III antiarrhythmic drug. Although radiofrequency ablation is a safe procedure, complications can occur. Depending on the location, these complications can be classified into those that affect the pulmonary veins themselves, cardiac complications, extracardiac intrathoracic complications, remote complications, and those that result from vascular access...
October 18, 2016: Radiología
Ivo Roca, Nuria Rivas, Jaume Francisco, Jordi Perez, Gabriel Acosta, Gerard Oristrell, Maria Terricabres, David Garcia-Dorado, Angel Moya
BACKGROUND: Ablation in aortic cusps could be necessary in up to 15% of the patients, especially in para-Hisian atrial tachycardia and ventricular arrhythmias arising from outflow tracts. Risk of coronary damage has led to recommendation of systematic coronary angiography (CA) during the procedure. Other image tests as intravascular (ICE) or transesophageal echocardiography (TEE) have been proposed. Both methods have limitations: additional vascular access for ICE and needing for additional CA in some patients in case of TEE...
October 19, 2016: Journal of Cardiovascular Electrophysiology
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
Anna Olasińska-Wiśniewska, Marek Grygier, Maciej Lesiak, Olga Trojnarska, Aleksander Araszkiewicz, Anna Komosa, Marcin Misterski, Marek Jemielity, Marek Proch, Stefan Grajek
BACKGROUND: In patients treated with transcatheter aortic valve implantation (TAVI), age is recognized as one of the most important risk factors. The aim of our study was to evaluate whether early and mid-term results of TAVI were worse in patients over 85 year old compared with the younger population. METHODS: From September 2010 to November 2015, 162 consecutive patients (mean age 78.4 ±7.1 years, 47.5 % females) underwent TAVI in our Institution. Patients were divided into two groups: 1) elderly (≥ 85 year old) and 2) younger patients (< 85 year old)...
October 17, 2016: Cardiology Journal
Isibor Arhuidese, Tammam Obeid, Besma Nejim, Satinderjit Locham, Caitlin W Hicks, Mahmoud B Malas
BACKGROUND: Restenosis after carotid endarterectomy (CEA) is associated with an increased risk of stroke, and the management of critical or symptomatic restenotic lesions poses a treatment challenge. The superiority of CEA vs carotid angioplasty and stenting (CAS) for restenosis remains debatable because existing studies are few and limited by small sample size or the inability to align interventions with ipsilateral events beyond the periprocedural period. We performed a population-based evaluation of CEA vs CAS in a large contemporary cohort of patients with carotid artery restenosis...
October 1, 2016: Journal of Vascular Surgery
Nicolas Majunke, Norman Mangner, Axel Linke, Enno Boudriot, Sandra Erbs, Franziska Tietz, Sabrina Wolff, Stephan Schürer, Gerhard Schuler, Marcus Sandri
OBJECTIVE: Surgical femoral cutdown for decannulation after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is considered standard practice. However, access-site complications with this technique are not rare. The objective of this study is to evaluate feasibility, safety, and efficacy of a complete percutaneous decannulation procedure after VA-ECMO compared with the conventional surgical cutdown approach. METHODS: In 35 patients who were successfully weaned from VA-ECMO support, femoral artery and vein access sites were closed using a completely percutaneous approach in 15 patients, whereas 20 patients had conventional surgical cutdown for access-site closure...
October 2016: Journal of Invasive Cardiology
Tim Seidler, Mark Hünlich, Miriam Puls, Gerd Hasenfuß, Claudius Jacobshagen
BACKGROUND: Despite the completion of more than 60,000 transcutaneous aortic valve implantations (TAVI) per year and an approximately 10-15 % incidence of vascular access site complications (VAC), there is a paucity of data on the efficacy and safety of percutaneous VAC treatment. HYPOTHESIS: Percutaneous endovascular treatment will be an effective treatment of VAC and associated with a low rate of surgical repair. Despite stent placement in proximity to the hip joint, endovascular treatment will be only rarely associated with disabling symptoms or complications...
September 29, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Lisa Kabelitz, Andrea Nonn, Kay W Nolte, Omid Nikoubashman, Ahmed Othman, Sarah Heringer, Martin Kramer, Martin Wiesmann, Marc A Brockmann
Minipigs are frequently used in (neuro-)interventional research. Longitudinal experiments may require repeated vessel access via the femoral artery. Anticoagulation and incompliance of the animals necessitates the use of a vascular closure device (VCD). The effects of the Angio-Seal VCD in minipigs were longitudinally assessed. Minipig (42±8.4 kg body weight) femoral arteries were sealed using the 8F (n = 6) or 6F (n = 7) Angio-Seal VCD. The pre-interventional femoral artery diameter was 5.1±0.4 mm (4.3-5...
2016: PloS One
Pierpaolo Di Nicolò, Marina Cornacchiari, Marco Mereghetti, Anna Mudoni
As a consequence of the central role of the arteriovenous fistula for dialysis (AVF) in the clinical management of the dialysis patient the necessity to limit the puncture-related complications to extend as much as possible the life of the vascular access. Accordingly, the AVF needling technique has gained growing attention. Alongside the traditional rope ladder (RL) puncture method, the buttonhole technique (BH) is increasingly popular; this technique employs the same cannulation sites of AVF in every dialysis associated with the use of dull needles to minimize vessels damage...
September 27, 2016: Seminars in Dialysis
Ashley Aaron, Selma El-Hag, Eileen de Grandis, Steve Santilli, Michael Rosenberg, Susan M Shafii, Jafar Golzarian, Rumi Faizer
PURPOSE: To report the results of percutaneous endovascular aortic aneurysm repair (PEVAR) using the superficial femoral artery (SFA) for large-bore vessel access. METHODS: We reviewed all PEVAR procedures at our institution over an 18-month period, identifying all patients who underwent PEVAR with the use of one or both SFAs for endograft delivery with dual ProGlide large-bore access closure. Indications for use of the SFA instead of the common femoral artery (CFA) included morbid obesity, CFA vessel wall disease, and scarring from previous CFA surgery...
September 22, 2016: Annals of Vascular Surgery
Shaoyong Wu, Jingxiu Huang, Zongming Jiang, Zhimei Huang, Handong Ouyang, Li Deng, Wenqian Lin, Jin Guo, Weian Zeng
BACKGROUND: A totally implantable venous access device (TIVAD) provides reliable, long-term vascular access and improves patients' quality of life. The wide use of TIVADs is associated with important complications. A meta-analysis was undertaken to compare the internal jugular vein (IJV) with the subclavian vein (SCV) as the percutaneous access site for TIVAD to determine whether IJV has any advantages. METHODS: All randomized controlled trials (RCTs) and cohort studies assessing the two access sites, IJV and SCV, were retrieved from PubMed, Web of Science, Embase, and OVID EMB Reviews from their inception to December 2015...
2016: BMC Cancer
Lennart van Gils, Joost Daemen, Greg Walters, Todd Sorzano, Todd Grintz, Sam Nardone, Mattie Lenzen, Peter P T De Jaegere, Gary Roubin, Nicolas M Van Mieghem
Catheter-based interventions have become a less invasive alternative to conventional surgical techniques for a wide array of cardiovascular diseases but often create large arteriotomies. A completely percutaneous technique is attractive as it may reduce the overall complication rate and procedure time. Currently, large bore arteriotomy closure relies on suture-based techniques. Access-site complications are not uncommon and often seem related to closure device failure. The MANTA VCD is a novel collagen-based closure device that specifically targets arteriotomies between 10 and 22 Fr...
September 18, 2016: EuroIntervention
Oscar A Mendiz, Carlos Fava, Gustavo Lev, Gaspar Caponi, León Valdivieso
AIMS: Limited data exist on radial access in carotid artery stenting (CAS). This single-center study was performed to compare the outcome and complication rates of transradial (TR) and transfemoral (TF) CAS. METHODS AND RESULTS: The clinical and angiographic data of 775 consecutive patients with high risk for carotid endarterectomy, treated between 1999 and 2016 by CAS with cerebral protection, were evaluated. Patients were divided into 2 groups according to vascular access: TR (n = 101; 13%) and TF (n = 674)...
September 16, 2016: Journal of Interventional Cardiology
Shefali Gupta, Shrikara P Mallya, Ashok Bhat, Shrikala Baliga
INTRODUCTION: Aerobic bacterial infections often complicate vascular access in patients receiving haemodialysis, leading to Catheter-Related Blood Stream Infections (CRBSI). Various studies report Gram - positive bacteria, Staphylococcus aureus (S. aureus) in particular, as the most common aetiologic agent. Studies on microbiological analysis in this subset of population from India are very few. AIM: To examine clinical and bacteriological profiles of haemodialysis patients developing CRBSI, the antibiotic susceptibility of the bacteria isolated from these patients and determine nasal carriage of S...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Stefano Rigattieri, Alessandro Sciahbasi, Karim Ratib, Alessandro Alonzo, Nicholas Cox, Piotr Chodór, Andrea Berni, Silvio Fedele, Francesco R Pugliese, Christopher J Cooper, Yves Louvard, James Nolan, Sunil V Rao
OBJECTIVES: Periprocedural bleedings, often related to vascular access site, represent an important drawback of percutaneous coronary procedures and are associated with worse outcomes. Radial access (RA) and, potentially, femoral access (FA) with vascular closure device (VCD) are useful strategies in order to mitigate periprocedural bleedings; nevertheless, their relative efficacy is largely undetermined. We aimed to perform a systematic review and meta-analysis of available studies comparing the efficacy of RA and FA with hemostasis by VCD (FA + VCD) on the reduction of access-site complications and/or periprocedural bleedings...
September 15, 2016: Journal of Invasive Cardiology
Nicolas W Shammas, Gail A Shammas, Thomas Harris, Cara M Voelliger, Andrew N Shammas, Michael Jerin
Bailout stenting of the common femoral artery (CFA) may become necessary with failed balloon angioplasty or atherectomy or in case of bleeding requiring a covered stent over the arteriotomy site. Reaccessing the CFA through a previously placed stent may occur during angiography. The safety and effectiveness of applying a closure device, or manual compression to achieve hemostasis through an accessed stented CFA are unknown. All patients in our practice that underwent CFA stenting were identified using billing records for 3 years (January 1, 2010-February 28, 2013)...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Ohad Oren, Michal Oren, Yoav Turgeman
This study aims to compare the clinical and procedural characteristics, including iatrogenic complications, of transradial versus transfemoral approach in patients who underwent peripheral arterial interventions. We retrospectively analyzed data of 72 patients who had undergone interventions of peripheral arteries in the preceding 3 years. Of all the procedures, 39 were performed using the transfemoral approach and 33 using the transradial approach. We assessed baseline clinical factors as well as procedure-related parameters (volume of contrast media, the amount of radiation, and duration of radiation exposure), rates of primary success, and acute vascular, access-site, or neurological complications...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Franklin Correa Barcellos, Bruno Pereira Nunes, Luciana Jorge Valle, Thiago Lopes, Bianca Orlando, Cintia Scherer, Marcia Nunes, Gabriela Araújo Duarte, Maristela Böhlke
BACKGROUND: Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. The aim of this study was to compare the effectiveness of 30 % trisodium citrate (TSC30 %) with heparin as CVC lock solutions in preventing catheter-related bloodstream infections (CRBSI) and dysfunction in hemodialysis patients...
August 29, 2016: Infection
Adel Aminian, Juan F Iglesias, Carlos Van Mieghem, Andrea Zuffi, Angela Ferrara, Roukos Manih, Dariouch Dolatabadi, Jacques Lalmand, Shigeru Saito
PURPOSE: To assess the feasibility and safety of the 7 French (Fr) Glidesheath Slender for complex transradial (TR) percutaneous coronary interventions (PCI). BACKGROUND: The TR approach is increasingly used worldwide for coronary and peripheral vascular interventions. However, the small size of the radial artery remains an important limitation for the use of large-bore guiding catheters (>6 Fr), restricting thereby the treatment of highly complex lesions through the TR approach...
August 27, 2016: Catheterization and Cardiovascular Interventions
Julia Seeger, Birgid Gonska, Christoph Rodewald, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Management of femoral access site is an important issue in transfemoral transcatheter aortic valve implantation (TAVI) and crucial for acute and long-term outcome. Data on vascular closure devices in this setting are limited. We evaluated safety and efficacy of the Prostar XL compared to the ProGlide suture-based vascular closure device. METHODS AND RESULTS: We enrolled 585 patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TAVI)...
November 15, 2016: International Journal of Cardiology
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