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Vascular access stenosis

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https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#1
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28430315/adding-access-blood-flow-surveillance-reduces-thrombosis-and-improves-arteriovenous-fistula-patency-a-randomized-controlled-trial
#2
Inés Aragoncillo, Soraya Abad, Silvia Caldés, Yésika Amézquita, Almudena Vega, Antonio Cirugeda, Cristina Moratilla, José Ibeas, Ramón Roca-Tey, Cristina Fernández, Nicolás Macías, Borja Quiroga, Ana Blanco, Maite Villaverde, Caridad Ruiz, Belén Martín, Asunción M Ruiz, Jara Ampuero, Fernando de Alvaro, Juan M López-Gómez
PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28410995/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-non-high-surgical-risk-severe-aortic-stenosis-a-systematic-review
#3
REVIEW
Tariq H Enezate, Arun Kumar, Mazen Abu Fadel, Mitul Patel, Ashraf Al Dadah, Jad Omran
OBJECTIVE: Transcatether aortic valve replacement (TAVR) has emerged as an acceptable alternative to surgical aortic valve replacement (SAVR) in patients with high-risk surgical profile. In this analysis, we compare both approaches in non-high surgical risk severe aortic stenosis. METHODS: Only studies comparing SAVR and TAVR and enrolling patients with low-intermediate risk were included from January 2000 through May 2016. Primary endpoints were assessed at 1 and 12months including: mortality, cerebrovascular accident (CVA) and myocardial infarction (MI)...
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28393400/sonography-of-arteriovenous-fistulas-and-grafts
#4
Jason A Pietryga, Mark D Little, Michelle L Robbin
Arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) are the vascular accesses of choice for long-term hemodialysis. Strategies to establish and maintain functioning AVFs and AVGs are essential. In addition to clinical evaluation, ultrasound plays a critical role in the evaluation and maintenance of AVFs and AVGs. AVFs have a high rate of failure to mature which can be reliably diagnosed with ultrasound. Treatable etiologies of the failure to mature can often be diagnosed with ultrasound. Causes of secondary AVG failure can also be diagnosed with ultrasound and treated...
April 10, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28393000/clinical-experience-with-ultrasound-guided-angioplasty-for-vascular-access
#5
Seong Cho, Yu-Ji Lee, Sung-Rok Kim
BACKGROUND: The use of ultrasound guided percutaneous transluminal angioplasty (UG-PTA), which use ultrasound as an imaging modality, is an evolving strategy. But, in Korea, this method is rarely used. We report our experiences with UG-PTA with respect to technical success rates and complication rates compared to conventional PTA (C-PTA), performed between 2010 and 2015 at Samsung Changwon Hospital, Korea. METHODS: In our series, 53 cases of UG-PTA and 90 cases of C-PTA were reviewed, respectively...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28388992/long-term-outcomes-of-560-consecutive-patients-treated-with-transcatheter-aortic-valve-implantation-and-propensity-score-matched-analysis-of-early-versus-new-generation-valves
#6
Amos Levi, Uri Landes, Abid R Assali, Katia Orvin, Ram Sharony, Hanna Vaknin-Assa, Ashraf Hamdan, Yaron Shapira, Shmuel Schwartzenberg, Pablo Codner, Aviv A Shaul, Mordechai Vaturi, Ariel Gutstein, Alexander Sagie, Ran Kornowski
Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in patients at high or prohibitive surgical risk. Nevertheless, long-term clinical and echocardiographic data are still lacking. We carried out an analysis of 560 consecutive patients who underwent TAVI at our institution from 2008 to 2016 to evaluate temporal changes in TAVI characteristics, predictors of 1-year and long-term outcomes, and to compare the performance of the early- and new-generation valve systems...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28383864/-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-with-severe-symptomatic-aortic-stenosis
#7
REVIEW
P Lancellotti, H Kulbertus
Aortic valve stenosis (AS) is the most commonly operated valvular heart disease in developed countries. Aortic valve replacement is the sole effective treatment of symptomatic patients. PARTNER-1 (Placement of AoRtic TraNscathetER Valves) has recently proved the efficacy of percutaneous aortic valve replacement (TAVI : Transcatheter Aortic Valve Implantation) in patients at high surgical risk, or inoperable. In the present article, we report and discuss the results of the PARTNER-2 study in intermediate risk patients...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28341502/significance-of-blunted-venous-waveforms-seen-on-upper-extremity-ultrasound
#8
Xuan-Binh D Pham, Ezinne J Ihenachor, Hoover Wu, Jerry J Kim, Amy H Kaji, Matthew C Koopmann, Timothy J Ryan, Christian de Virgilio
INTRODUCTION: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVW) suggest central venous stenosis; however, this relationship and one between BVW and the presence of a central venous catheter (CVC) remain unclear. MATERIAL AND METHODS: All patients who received upper-extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28330437/long-term-outcomes-of-fistula-first-initiative-in-an-urban-university-hospital-is-it-still-relevant
#9
Jacques Greenberg, Senthil Jayarajan, Sridhar Reddy, Frank A Schmieder, Andrew B Roberts, Paul S van Bemmelen, Jean Lee, Eric T Choi
PURPOSE: Dialysis access failure is a major cause of morbidity in patients with end-stage renal disease. The Fistula First Breakthrough Initiative (FFBI) dictates arteriovenous fistulae (AVFs) should be preferred over arteriovenous grafts (AVGs) as first line for surgically placed accesses. The purpose of this study was to compare patency rates of surgical dialysis accesses in our mature, urban population after the FFBI. METHODS: Current dialysis patients with accesses placed between 2006 and 2011 were included...
April 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28326557/analysis-of-blood-flow-characteristics-in-a-model-of-a-mature-side-to-side-arteriovenous-fistula
#10
Ashkan Javadzadegan, Nay Myo Lwin, Muhammad Asyraf, Anne Simmons, Tracie Barber
The creation of an arteriovenous fistula (AVF) is a common surgical procedure in hemodialysis patients suffering from end-stage renal disease (ESRD). However, several complications may occur after surgery, including thrombosis, stenosis, and aneurysm. These complications are attributed to hemodynamics perturbations including pathophysiological wall shear stress (WSS) and flow recirculation zones. In this study, we present a computational hemodynamic analysis in a model of a mature side-to-side AVF, which is then validated by experimental measurements...
March 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28297068/drug-eluting-balloons-for-resistant-arteriovenous-dialysis-access-stenosis
#11
Dimitrios Karnabatidis, Panagiotis Kitrou
Vascular access maintenance is vital for hemodialysis patients. Conventional balloon angioplasty is the gold standard of treatment in endovascular therapy according to published guidelines, accompanied by bare metal stents as a bail-out method. Several devices have been used so far with a view to improve patency outcomes, but only covered stents have been proposed as a valid alternative and only for venous juxta-anastomotic stenosis of arteriovenous grafts. Paclitaxel-coated balloons (PCBs) have been extensively investigated in the last few years in pilot studies with small numbers of patients in dialysis access...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297064/endovascular-treatment-of-swing-segment-stenosis-in-vascular-access-current-status-and-future-directions
#12
Rick de Graaf
Swing-segment lesions are a fairly common reason for access failure and predispose to repeated interventions. The pathophysiology, hemodynamic circumstances and the primary intervention might all play a role in early recurrence. Mainly, percutaneous transluminal angioplasty (PTA), bare metal stenting and stent graft implantation have been performed to prolong lesion patency and access circuit patency. The available data on endovascular treatment of swing-segment lesions are scarce, heterogeneous and of poor quality...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28297058/stent-grafts-for-treatment-of-cannulation-zone-stenosis-and-arteriovenous-graft-venous-anastomosis
#13
David Shemesh, Ilya Goldin, Oded Olsha
Stent grafts (SGs) are widely used for treatment of failing vascular accesses, fistulas and grafts. The mechanical barrier of the covered stent prevents in-stent stenosis and can be used to effectively correct ruptured vein and aneurysms. Treatment of cannulation zone stenosis with SG can be justified when its use is obligatory, in order to prevent total access loss. Although there are worrying complications attendant on SG insertion and cannulation, including jeopardizing future access creation, most studies report no complications of SG in cannulation zone stenosis...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28290908/-coronary-angioplasty-and-stenting-in-patients-older-than-80-years-immediate-and-long-term-results
#14
A M Babunashvili, D P Dundua, D S Kartashov, A A Bazarnova, A Yu Korenevich, M E Vetluzhskikh
AIM: to assess immediate and long-term results of coronary angioplasty and stenting in patients older than 80 years - a high risk group in view of the severity of concomitant pathology and extent of coronary atherosclerosis. MATERIAL AND METHODS: We conducted retrospective analysis of data from 167 patients older than 80 years (mean age 81.43+/-2.14 years) subjected to percutaneous coronary intervention from 2006 to 2013 (3.2% from total number of patients). Multivessel involvement was present in 128 patients (76...
July 2016: Kardiologiia
https://www.readbyqxmd.com/read/28279411/dialysis-catheter-placement-in-patients-with-exhausted-access
#15
Syed Rahman, Joshua D Kuban
Patients with end-stage renal disease undergo renal transplant, peritoneal dialysis, or intermittent hemodialysis for renal replacement therapy. For hemodialysis, native fistulas or grafts are preferred but hemodialysis catheters are often necessary. Per KDOQI, the right jugular vein is the preferred vessel of access for these catheters. However, in patients with long-standing end-stage renal disease vein thrombosis, stenosis and occlusion occurs. In these patients with end-stage vascular access, unconventional routes of placement of dialysis catheters are needed...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28279409/central-venous-interventions
#16
Masahiro Horikawa, Keith B Quencer
Central venous stenosis or occlusion is a common and vexing problem in patients undergoing hemodialysis. Typical presenting symptoms include arm swelling and prolonged bleeding after hemodialysis. Despite multiple treatment approaches, these stenoses tend to recur and progress over time. A thorough preprocedure evaluation, methodical procedural approach and awareness of potential complications are all essential to try to preserve vascular access and improve patients' quality of life.
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28228304/24h-and-30-day-outcome-of-perclose-proglide-suture-mediated-vascular-closure-device-an-indian-experience
#17
Desabandhu Vinayakumar, Shajudeen Kayakkal, Sandeep Rajasekharan, Julian Johny Thottian, Prasanth Sankaran, Cicy Bastian
INTRODUCTION: Advantages of vascular closure device over manual compression include patient comfort, early mobilisation and discharge, avoidance of interruption of anticoagulation, avoidance of local compression and its sequelae and less time constraint on staff. No published Indian data exist regarding Perclose Proglide suture mediated vascular closure device (SMC). AIM: To study the 24h and 30 day outcome of Perclose Proglide SMC retrospectively. STUDY DESIGN: Retrospective observational study conducted in the Department of Cardiology, Government Medical College, Calicut, Kerala from June 2013 to June 2015...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28218365/a-comparison-of-efficacy-of-endovascular-versus-surgical-repair-for-the-treatment-of-arteriovenous-fistula-stenosis-in-taiwan
#18
Szu-Shan Fan, Chien-Wen Chen, Kuo-Cheng Lu, Hung-Chung Mao, Miao-Pei Chen, Chu-Lin Chou
BACKGROUND: Percutaneous transluminal angioplasty (PTA) and fistula reconstruction surgery are therapeutic options for vascular access occlusion in hemodialysis patients. However, owing to its convenience, PTA has gradually become the preferred therapeutic option for fistula stenosis or occlusion. This study investigated the effects of the two therapeutic methods on the vascular access maintenance duration (number of days) and maintenance costs of fistula in dialysis patients from different dialysis units...
February 15, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28183467/initial-experience-of-a-second-generation-self-expanding-transcatheter-aortic-valve-the-uk%C3%A2-ireland-evolut-r-implanters-registry
#19
Sundeep S Kalra, Sami Firoozi, James Yeh, Daniel J Blackman, Shabnam Rashid, Simon Davies, Neil Moat, Miles Dalby, Tito Kabir, Saib S Khogali, Richard A Anderson, Peter H Groves, Darren Mylotte, David Hildick-Smith, Rajiv Rampat, Jan Kovac, Ashan Gunarathne, Jean-Claude Laborde, Stephen J Brecker
OBJECTIVES: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve. BACKGROUND: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications. METHODS: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183466/early-clinical-outcomes-after-transcatheter%C3%A2-aortic-valve-replacement-using-a-novel-self-expanding-bioprosthesis%C3%A2-in%C3%A2-patients-with-severe%C3%A2-aortic%C3%A2-stenosis-who-are-suboptimal%C3%A2-for%C3%A2-surgery-results-of-the-evolut-r-u-s-study
#20
Jeffrey J Popma, Michael J Reardon, Kamal Khabbaz, J Kevin Harrison, G Chad Hughes, Susheel Kodali, Isaac George, G Michael Deeb, Stan Chetcuti, Robert Kipperman, John Brown, Hongyan Qiao, James Slater, Mathew R Williams
OBJECTIVES: This study sought to evaluate this transcatheter aortic valve (TAV) bioprosthesis in patients who are poorly suitable for surgical aortic valve (AV) replacement. BACKGROUND: A novel self-expandable TAV bioprosthesis was designed to provide a low-profile delivery system, conformable annular sealing, and the ability to resheath and reposition during deployment. METHODS: The Evolut R U.S. study included 241 patients with severe aortic stenosis who were deemed to be at least high risk for surgery treated at 23 clinical sites in the United States...
February 13, 2017: JACC. Cardiovascular Interventions
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