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vascular access site complication

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https://www.readbyqxmd.com/read/28934599/rewarming-after-severe-accidental-hypothermia-using-the-esophageal-heat-transfer-device-a-case-report
#1
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/28900715/radial-versus-femoral-access-site-for-percutaneous-coronary-intervention-in-patients-suffering-acute-myocardial-infarction-a%C3%A2-randomized-prospective-multicenter-trial
#2
Christiana Schernthaner, Matthias Hammerer, Stefan Harb, Matthias Heigert, Kurt Hoellinger, Elisabeth Lassnig, Edwin Maurer, Jochen Schuler, Peter Siostrzonek, Hanno Ulmer, Andreas Winter, Johann Altenberger
BACKGROUND: Transradial access (TRA) in percutaneous coronary intervention (PCI) is a widely used standard technique with lower complication rates compared to transfemoral access (TFA). The aim of this study was to evaluate the impact of TRA versus TFA for PCI on clinically significant vascular access complications in the setting of acute myocardial infarction (AMI). METHODS: This multicenter study randomly assigned 250 patients in a 1:1 fashion (TRA vs. TFA) admitted with or without ST-segment elevation AMI undergoing immediate PCI...
September 12, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#3
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/28859467/transradial-versus-transfemoral-intervention-in-st-segment-elevation-myocardial-infarction-patients-in-korean-population
#4
Hu Li, Seung-Woon Rha, Byoung Geol Choi, Min Suk Shim, Se Yeon Choi, Cheol Ung Choi, Eung Ju Kim, Dong Joo Oh, Byung Ryul Cho, Moo Hyun Kim, Doo-Il Kim, Myung-Ho Jeong, Sang Yong Yoo, Sang-Sik Jeong, Byung Ok Kim, Min Su Hyun, Young-Jin Youn, Junghan Yoon
Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study...
July 7, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28854967/innovative-dressing-and-securement-of-tunneled-central-venous-access-devices-in-pediatrics-a-pilot-randomized-controlled-trial
#5
Amanda J Ullman, Tricia Kleidon, Victoria Gibson, Craig A McBride, Gabor Mihala, Marie Cooke, Claire M Rickard
BACKGROUND: Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure...
August 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28854521/substitution-rate-based-screening-model-to-assess-stenosis-progression-in-experimental-stenotic-arteriovenous-grafts
#6
Chung-Dann Kan, Wei-Ling Chen, Chia-Hung Lin, Ming-Jui Wu, Yi-Chen Mai
An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model...
August 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28833996/the-closer-trial-a-multi-center-study-on-the-clinical-safety-and-effectiveness-of-closer-tm-vss-a-novel-resorbable-transfemoral-vascular-access-sealing-system
#7
S Chiu Wong, Roger Gammon, William Bachinsky, Charles O'Shaughnessy, Wayne Leimbach, Nelson Bernardo, Nick Cavros, Michael R Jaff, Ping-Yu Liu, Geoffrey Bergman
OBJECTIVES: To evaluate the safety and effectiveness of the Closer Vascular Sealing System (VSS) against prespecified performance goals (PGs) in sealing femoral arterial access following 5-7 Fr procedures. BACKGROUND: Inconsistent safety profiles, costs and learning curves of earlier generation vascular closure devices have limited their widespread use following transfemoral procedures. METHODS: In this prospective single-arm, multi-center trial, we compared the clinical outcomes in patients undergoing 5-7 Fr transfemoral diagnostic or interventional procedures and access sites managed with Closer VSS against pre-specified PGs...
August 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28823140/pre-existing-arterial-pathologic-changes-affecting-arteriovenous-fistula-patency-and-cardiovascular-mortality-in-hemodialysis-patients
#8
REVIEW
Ja Young Lee, Young Ok Kim
The radiocephalic arteriovenous fistula (AVF) provides optimal vascular access for hemodialysis; it has a higher long-term patency rate and fewer complications than other vascular access methods. However, the AVF has a high primary failure rate. The presence of small-diameter vessels at anastomosis sites is an important risk factor for AVF failure. However, in a recent study, despite selecting an adequate artery and vein for creating an AVF by routine preoperative vascular mapping, AVF maturation and primary failure occurred...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28794652/stent-tunnel-technique-to-save-thrombosed-native-hemodialysis-fistula-with-extensive-venous-aneurysm
#9
Martin Rabellino, Guillermo J Rosa-Diez, Sergio A Shinzato, Pablo Rodriguez, Oscar A Peralta, Maria S Crucelegui, Rosario Luxardo, Agustina Heredia-Martinez, Mariela I Bedini-Rocca, Ricardo D García-Mónaco
INTRODUCTION AND PURPOSE: The increasing number of patients undergoing hemodialysis and the limited number of access sites have resulted in an increasing number of techniques to maintain vascular access for hemodialysis. Thrombosed arteriovenous (AV) fistulas with large venous aneurysms have poor treatment results, with both endovascular and surgical techniques, leading to a high rate of definitive AV access loss. The purpose of this study was to review the feasibility and initial results of this novel endovascular treatment of thrombosed AV fistulas with large venous aneurysms...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28777412/atypical-use-of-picc-in-infants-and-small-children-a-unicentric-experience
#10
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/28766859/transulnar-cardiac-catheterization-and-percutaneous-coronary-intervention-techniques-transradial-comparisons-anatomical-considerations-and-comprehensive-literature-review
#11
Subrata Kar
Ulnar arterial access for cardiac catheterization and intervention is an alternative approach compared with radial or femoral access. Ulnar access is infrequently performed since the radial artery is readily palpable and is commonly used worldwide to minimize vascular complications from femoral access. Nevertheless, ulnar access provides a suitable access site in patients who are poor candidates for femoral access, have pre-existing radial occlusion, radial artery hypoplasia or hyperplasia from prior radial artery procedures, radial stenosis, radial loops, radial tortuosity, small radial arteries, and/or have future need for radial graft for dialysis or coronary artery bypass graft...
August 2, 2017: Catheterization and Cardiovascular Interventions
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/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#13
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28757286/transradial-versus-transfemoral-access-for-hepatic-chemoembolization-intrapatient-prospective-single-center-study
#14
Roberto Iezzi, Maurizio Pompili, Alessandro Posa, Eleonora Annicchiarico, Matteo Garcovich, Biagio Merlino, Elena Rodolfino, Vincenzo Di Noia, Michele Basso, Alessandra Cassano, Carlo Barone, Antonio Gasbarrini, Riccardo Manfredi, Cesare Colosimo
PURPOSE: To compare transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference. MATERIALS AND METHODS: A single-center prospective intrapatient comparative study was conducted with 42 consecutive patients with hepatic malignancies who received 2 consecutive treatment sessions of unilobar hepatic chemoembolization within a 4-week interval over a 6-month period with both TRA and TFA...
July 27, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28743227/suitability-of-a-7-f-exoseal-vascular-closure-device-for-femoral-artery-punctures-made-by-8-f-or-9-f-introducer-sheaths
#15
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Toshihisa Nishizawa, Shinji Shimato, Kyozo Kato
PURPOSE: To establish the safety and efficacy of the 7-F ExoSeal device for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths. METHODS: Between January 2013 and December 2016, 332 patients (mean age 68.4±12.1 years; 195 men) underwent neurointerventional procedures via percutaneous puncture of the common femoral artery and an 8-F (n=272, 81.9%) or 9-F (n=60, 18.1%) introducer. The access sites were sealed with a 7-F ExoSeal in all cases...
August 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28737069/safety-of-radial-access-for-primary-percutaneous-intervention-in-patients-with-st-elevation-acute-myocardial-infarction-results-from-a-low-volume-center
#16
Yoshimasa Tsurumaki, Yumiko Haraguchi, Tomohiro Nakamura
Radial access for primary percutaneous coronary intervention (pPCI) in patients with ST-elevation acute myocardial infarction (STEMI) is recommended in high-volume experienced centers. This study investigated whether radial access for pPCI is safe even in a low-volume center. We performed radial access for pPCI in 171 patients. Major adverse cardiac events (total death, myocardial infarction, stroke) rate was 1.2%. The overall incidence of bleeding complications was 2.4%; there was no vascular complication at the access site...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28708034/ultrasound-guided-percutaneous-common-carotid-artery-access-in-piglets-for-intracoronary-stem-cell-infusion
#17
Jason H Anderson, Nathaniel W Taggart, Sarah L Edgerton, Susana Cantero Peral, Kimberly A Holst, Frank Cetta
In pigs, the deep location of the common carotid artery and overlying sternomastoideus muscle in the neck has led to the recommendation for a surgical cutdown for common carotid access, as opposed to minimally invasive techniques for vascular access. We sought to determine if direct percutaneous common carotid artery access in piglets is attainable. Seventeen piglets were anesthetized and intubated. Under two-dimensional and color flow Doppler ultrasound guidance, a 21 gauge needle was utilized to access the right common carotid artery...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28705072/short-and-long-term-results-after-endovascular-management-of-vascular-complications-during-transfemoral-aortic-valve-implantation
#18
Thomas Heger, Stefanie Strauß, Erwin Blessing, Martin Andrassy, Christian Erbel, Oliver J Müller, Emmanuel Chorianopoulos, Sven Pleger, Florian Leuschner, Grigorios Korosoglou, Raffi Bekeredjian, Hugo A Katus, Britta Vogel
Background Vascular injury and access site complications in the contemporary setting of transcatheter aortic valve implantation (TAVI) are known to be associated with increased mortality and morbidity. The aim of our study was to analyse the feasibility and safety of percutaneous treatment of such vascular complications using a stent graft. Methods Between January 2010 and April 2013, 36 TAVI patients developed severe access site complications and underwent subsequent interventional treatment with a covered stent...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28688516/pancreas-transplantation-advantages-of-a-retroperitoneal-graft-position
#19
Joana Ferrer, Víctor Molina, Ramón Rull, Miguel Ángel López-Boado, Santiago Sánchez, Rocío García, Ma José Ricart, Pedro Ventura-Aguiar, Ángeles García-Criado, Enric Esmatjes, Josep Fuster, Juan Carlos Garcia-Valdecasas
INTRODUCTION: In the 50 years since the first pancreas transplant performed at the University of Minnesota, the surgical techniques employed have undergone many modifications. Techniques such as retroperitoneal graft placement have further improved the ability to reproduce the physiology of the «native» pancreas. We herein present our experience of a modified technique for pancreatic transplant, with the organ placed into a fully retroperitoneal position with systemic venous and enteric drainage of the graft by duodeno-duodenostomy...
July 5, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28673782/percutaneous-closure-of-periprosthetic-paravalvular-leaks-a-viable-alternative-to-surgery
#20
Ana Isabel Azevedo, Pedro Braga, Alberto Rodrigues, Lino Santos, Bruno Melica, José Ribeiro, Francisco Sampaio, Ricardo Fontes-Carvalho, Marlene Fonseca, Adelaide Dias, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: Paravalvular leak (PVL) is a possible complication after prosthetic valve implantation. PVL can cause significant symptoms of congestive heart failure and/or hemolysis. Medical therapy is palliative and reoperation has a high mortality rate. Percutaneous transcatheter closure is a promising alternative for symptomatic patients at high surgical risk. We aim to review the efficacy and safety of percutaneous PVL closure in a consecutive series of patients referred to our center...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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