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Central venous stenosis

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
Michel Kindo, Tam Hoang Minh, Stéphanie Perrier, Hélène Petit-Eisenmann, Jonathan Bentz, Mircea Cristinar, Gharib Ajob, Olivier Collange, Jean-Philippe Mazzucotelli
OBJECTIVES: Prosthesis-patient mismatch (PPM) has been reported to impact early haemodynamic status and early mortality after prosthetic aortic valve replacement (AVR) in patients with aortic stenosis (AS). The aim of this study was to assess the impact of PMM on early haemodynamic status after AVR using vasoactive-inotropic dependency index (VDI), postoperative pressures and end-organ perfusion. METHODS: A total of 183 patients with AS were included in this prospective cohort study, and underwent elective AVR with or without combined coronary artery bypass graft surgery...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
Elçin Aydin, Mustafa Gök, Asım Esenkaya, Celal Çinar, İsmail Oran
AIM: We aimed to evaluate iatrogenic vascular injuries in craniocervical region and their endovascular management. MATERIAL AND METHODS: Twenty-one patients (nine women, twelve men) with a mean age of 53.6 (range 16-87 years), who underwent endovascular embolization for iatrogenic vascular injury in craniocervical region between December 2000 and October 2015 were included in this retrospective study. Types of iatrogenic injuries, etiologies that caused these injuries and details of endovascular managements were reported...
July 1, 2016: Turkish Neurosurgery
Dr Charlotte Ratcliff, Miss Monica Hansrani
INTRODUCTION: This case report intends to highlight the Haemodialysis Reliable Outflow (HeRO) graft as a potential long term option for ongoing dialysis in patients with central venous stenosis. PRESENTATION OF CASE: A 55year old patient, who developed end stage renal failure (ESRF) after chemotherapy treatment for breast cancer, presented at the limit of her dialysis access after a 15year haemodialysis history causing central vein stenosis. The patient was initially started on peritoneal dialysis but after repeated peritonitis was switched to haemodialysis...
2016: International Journal of Surgery Case Reports
Joseph Kuhn, Ahmet Kilic, Erica Stein
Although vessel perforation rarely occurs during percutaneous transluminal angioplasty of a central venous stenosis, it can be a rapidly fatal complication when accompanied by pericardial tamponade. The present case report details our experience with this dangerous complication. It also highlights the risk factors for and the pathogenesis of central venous stenosis, the clinical findings associated with inadvertent vessel perforation during an intervention, and anesthetic management strategies for pericardial tamponade resulting from vessel perforation...
August 15, 2016: A & A Case Reports
M Lobo, M Saxena, P A Sobotka, C Ott, E Dolan, J Foran, S S Furniss, J Cockcroft, M Van Der Giet, J Hoyer, A Januszewicz, G A Ng, B Rensing, B Scott, D Schoors, A Stanton, N Sulke, C Tsioufis, A Witkowski, R E Schmieder
OBJECTIVE: Creation of a central iliac arteriovenous (AV) anastomosis using a novel nitinol coupler device results in an immediate, significant reduction of blood pressure (BP). We present efficacy and safety findings at 12 months post coupler insertion, extending the initial 6 month primary endpoint report (Lancet 2015). DESIGN AND METHOD: This open-label, multicentre, prospective, randomised trial, enrolled patients with a baseline office systolic blood pressure (SBP) >140 mmHg, average daytime ambulatory SBP > 135 mmHg, and ambulatory diastolic blood pressure (DBP) > 85 mmHg...
September 2016: Journal of Hypertension
Vinay Narasimha Krishna, Joseph B Eason, Michael Allon
Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS...
August 1, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Duncan A Meiklejohn, Dylan K Chan, M Lauren Lalakea
Subtotal parathyroidectomy may be indicated in patients with chronic renal failure and tertiary hyperparathyroidism, a population at increased risk for central venous stenosis (CVS) due to repeated vascular access. Here we report a case of complete upper airway obstruction precipitated by subtotal parathyroidectomy with ligation of anterior jugular vein collaterals in a patient with occult CVS. This case demonstrates a previously unreported risk of anterior neck surgery in patients with chronic renal failure...
July 2016: Ear, Nose, & Throat Journal
Lewis Meecham, Owain Fisher, George Kirby, Richard Evans, Pauline Buxton, Jocelyn Legge, Sriram Rajagopalan, John Asquith, Arun Pherwani
PURPOSE: We present a case of external iliac vein patch venoplasty to accommodate rescue vascular access via a PTFE loop arterio-venous fistula Graft (AVG) for a patient with multiple central venous stenoses. METHODS: A 35 year old female with anti-glomerular basement membrane antibody disease required rescue vascular access for haemodialysis. Repeated occlusion and/or thrombosis of long term central venous access canulae, to facilitate dialysis, had caused stenosis of brachiocephalic veins; right external iliac vein and occlusion of the left common iliac vein...
July 13, 2016: Annals of Vascular Surgery
Ki Hyun Kim, Sang Woo Park, Il Soo Chang, Younghee Yim
PURPOSE: To evaluate the dwell time and actual survival rates of peripherally inserted central catheter (PICC) placements after balloon angioplasty in patients with unexpected central venous obstructions. MATERIALS AND METHODS: Data were obtained on all PICC insertions performed in a tertiary care hospital from August 2008 to December 2013. Thirty-five PICCs attempted after balloon angioplasty in 25 patients (15 male and 10 female patients; mean age, 63 years). Fisher's exact test was used to test for differences in reasons for catheter removal between the groups of patients with stenosis or obstructions...
September 21, 2016: Journal of Vascular Access
Vishal B Parekh, Vandana D Niyyar, Tushar J Vachharajani
Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered difficulties in clinical practice include (1) a high incidence of central venous catheter-related central vein stenosis and (2) limited options for creating a functioning upper extremity permanent arteriovenous access...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Se K Park, In S Lee, You S Song, Jin Il Moon, Jong W Song, Hee Kang
OBJECTIVE: The purpose of this study was to evaluate the correlation between the dilatation of the spinal epidural venous plexus (SEVP) and the amount of epidural fat (EF). METHODS: Between January 2007 and January 2012, 116 patients with prominent EF and 116 control subjects without prominent EF were included in this study. On the lumbar MR images, we graded the amount of EF and counted the number of vertebrae to determine the longitudinal extent of the EF. We evaluated and classified the dilatation of the SEVP and the degree of central canal stenosis...
July 2016: British Journal of Radiology
Yong Shu Diao, Yan Huan Feng, Chun Cheng Liu, Tian Lei Cui, Ping Fu
The patency of vascular access is of vital importance to dialysis patients. Access dysfunction is largely caused by vessel stenosis and thrombosis. Nephrologists usually find themselves helpless when all treatments fail and the vascular access seems to have exhausted. Here we report a successful establishment of vascular access through superior vena cava for a critical patient with multiple central venous stenosis or occlusion. To our knowledge, it is the first case ever reported on the successful establishment of vascular access through superior vena cava under such a complicated condition of vascular exhaustion...
May 2016: JPMA. the Journal of the Pakistan Medical Association
Narayan Karunanithy, Irene Rebollo Mesa, Anthony Dorling, Francis Calder, Konstantinos Katsanos, Vikki Semik, Emily Robinson, Janet Peacock, Neelanjan Das, Colin Forman, Sarah Lawman, Kate Steiner, C Jason Wilkins, Michael G Robson
BACKGROUND: The initial therapy for a stenosis in an arteriovenous fistula used for haemodialysis is radiological balloon dilatation or angioplasty. The benefit of angioplasty is often short-lived, intervention-free survival is reported to be 40-50 % at 1 year. Previous small studies and observational data suggest that paclitaxel-coated balloons may be of benefit in improving outcomes after fistuloplasty of stenotic arteriovenous fistulae. METHODS/DESIGN: We have designed a multicentre, double-blind randomised controlled trial to test the superiority of paclitaxel-coated balloons for preventing restenosis after fistuloplasty in patients with a native arteriovenous fistula...
2016: Trials
Varun Mittal, Aneesh Srivastava, Rakesh Kapoor, Hira Lal, Tarun Javali, Sanjoy Sureka, Nitesh Patidar, Sohrab Arora, Manoj Kumar
INTRODUCTION: Venous hypertension (VH) is a distressing complication following the creation of arteriovenous fistula (AVF). The aim of management is to relieve edema with preservation of AVF. Extensive edema increases surgical morbidity with the loss of hemodialysis access. We present our experience in management of VH. METHODS: A retrospective study was conducted on 37 patients with VH managed between July 2005 to May 2014. Patient demographics, evaluation, and procedures performed were noted...
April 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Behrad Ziapour
BACKGROUND: To describe the successful management of a patient with severe dyspnea and hypoxia due to tracheal stenosis by the application of a novel bridging technique-anterograde tracheal catheterization-prior to tracheostomy. CASE PRESENTATION: A 55-year-old woman entered the Emergency Department with severe dyspnea, tachypnea, and stridor and a pulse oximetry reading of 60 %. An attempt at intubation failed because of tracheal stenosis discovered 3-4 cm distal to the vocal cords, which had been formed as a complication of intubation the previous month...
2016: Journal of Cardiothoracic Surgery
Pietro Quaretti, Franco Galli, Lorenzo Paolo Moramarco, Riccardo Corti, Giovanni Leati, Ilaria Fiorina, Carmine Tinelli, Giovanni Montagna, Marcello Maestri
PURPOSE: To compare patency in dialysis patients following different endovascular treatment of symptomatic central venous stenosis. MATERIALS AND METHODS: A 10-year retrospective evaluation in 70 patients (32 men) dialyzing through vascular access (33, 47%) and tunneled catheters (37, 53%) was made. Three cohorts were compared: angioplasty alone (22), bare metal stent (28), and stent graft (20). Patencies were described with Kaplan-Meier method, and Cox uni- and multivariate models were analyzed to find factors associated...
May 2016: Vascular and Endovascular Surgery
Phillip Ribeiro, Swetal Patel, Rizwan A Qazi
Central venous stenosis is a well-known complication in patients with vascular access for hemodialysis. We report two cases involving patients on hemodialysis with arteriovenous fistulas who developed reversible unilateral conductive hearing loss secondary to critical stenosis of central veins draining the arteriovenous dialysis access. A proposed mechanism for the patients' reversible unilateral hearing loss is pterygoid venous plexus congestion leading to decreased Eustachian tube patency. Endovascular therapy was conducted to treat the stenosis and the hearing loss of both patients was returned to near normal after successful central venous angioplasty...
2016: Journal of Vascular Access
Jordan Breed, Tony Goldschlager, Ronil V Chandra
BACKGROUND CONTEXT: Neurogenic claudication from posterior epidural extension of a Baastrup interspinous bursal cyst is rare. Surgical decompression is the gold standard of treatment. This case report describes successful percutaneous treatment with good early clinicoradiological outcome. PURPOSE: This study aimed to describe the successful percutaneous treatment of a central posterior epidural Baastrup cyst causing neurogenic claudication. STUDY DESIGN: This is a case report study...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Evrim Ozmen, Oktay Algin
Venous anomalies are diagnostic and therapeutic challenges. Subclavian or superior vena cava stenosis can be developed and venous return can be achieved via cardiac veins and coronary sinus in patients with central venous catheter for long-term hemodialysis. These types of abnormalities are not extremely rare especially in patients with a history of central venous catheter placement. Detection of these anomalies and subclavian vein stenosis before the surgical creation of hemodialysis fistulae or tunneled central venous catheter placement may prevent unnecessary interventions in those patients...
2016: Journal of Vascular Access
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