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Vascular access stenosis

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https://www.readbyqxmd.com/read/27909474/efficacy-high-procedural-safety-and-rapid-optimization-of-cryoballoon-atrial-fibrillation-ablation-in-the-hands-of-a-new-operator
#1
Eberhard Scholz, Patrick Lugenbiel, Patrick A Schweizer, Panagiotis Xynogalos, Claudia Seyler, Edgar Zitron, Rüdiger Becker, Hugo A Katus, Dierk Thomas
BACKGROUND: Cryoballoon (CB) ablation is successful in eliminating atrial fibrillation (AF). PURPOSE: The purpose of this study was to assess procedural efficacy and safety of CB ablation performed by a newly trained operator. METHODS: Forty patients with documented paroxysmal AF (58 ± 11 years, 26 male) undergoing CB catheter ablation were prospectively enrolled. RESULTS: Electrical pulmonary vein (PV) isolation was achieved in all patients (156 PVs)...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907904/a-new-cryoenergy-for-ventricular-tachycardia-ablation-a-proof-of-concept-study
#2
Benjamin Berte, Frédéric Sacher, Jean-Yves Wielandts, Saagar Mahida, Xavier Pillois, Rukshen Weerasooriya, Olivier Bernus, Pierre Jaïs
INTRODUCTION: Lack of transmural lesion formation during radiofrequency (RF) ablation for ventricular tachycardia (VT) is an important determinant of arrhythmia recurrence. The aim of this proof-of-concept study was to evaluate safety and efficacy of a new and more powerful cryoablation system for ventricular ablation. METHODS AND RESULTS: Five healthy female sheep (59 ± 6 kg) underwent a surgical sternotomy for epicardial and endocardial access [endocardial access via right atrial appendage and left ventricular (LV) apex]...
October 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27903478/the-clinical-efficacy-of-balloon-assisted-maturation-of-autogenous-arteriovenous-fistulae
#3
Syed Ali Rizvi, Fred Usoh, Anil Hingorani, Eleanor Iadgarova, Pamela Boniscavage, Justin Eisenberg, Enrico Ascher, Natalie Marks
OBJECTIVE: Delayed maturation of arteriovenous fistulae (AVF) among patients who require hemodialysis (HD) can lead to catheter sepsis with its resultant morbidity and mortality. Some have proposed that sequential balloon-assisted maturation (BAM) may accelerate the maturation times of these accesses. On the other hand, serial balloon angioplasty of normal vein may result in stenosis and delay maturation. Although the safety of BAM has been shown, direct comparison to non-matured AVF has not been explored...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27866966/complications-of-vascular-access-superior-vena-cava%C3%A2-syndrome
#4
Anil K Agarwal, Hooman Khabiri, Nabil J Haddad
Stenosis or occlusion of central veins in hemodialysis patients is common, especially with previous intravascular catheter or device use. Superior vena cava (SVC) obstruction is emerging as a frequent chronic complication of central vein cannulation that not only jeopardizes the availability of vascular access for hemodialysis, but can become a life-threatening emergency. Clinical features of SVC syndrome can be subtle or dramatic, including facial swelling and shortness of breath, which require expeditious attention and intervention...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27862938/combined-percutaneous-trans-renal-and-trans-femoral-endovascular-recanalization-and-angioplastic-reconstruction-of-a-disrupted-transplant-renal-artery-stent-a-novel-salvage-technique
#5
Dustin J Carpenter, Sumit Mohan, Lloyd E Ratner, Peter Schlossberg
Renal artery stenosis (RAS) is the most common vascular complication following renal transplantation. Percutaneous endovascular transluminal angioplasty with stenting is the treatment of choice for clinically significant RAS. We present a case describing a novel combined trans-renal parenchyma and trans-femoral approach to repairing a disrupted transplant renal artery stent. Our patient's allograft RAS was initially managed by standard percutaneous approach, but during follow-up the stent became disrupted and crushed causing partial occlusion of the renal artery...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27845874/initial-single-center-experience-with-the-fully-repositionable-transfemoral-lotus-aortic-valve-system
#6
Kai-Uwe Jarr, Florian Leuschner, Benjamin Meder, Hugo A Katus, Raffi Bekeredjian, Emmanuel Chorianopoulos
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the standard therapy for patients with severe symptomatic aortic stenosis and unacceptable high risk for surgical aortic valve replacement. Several different devices for TAVR have been introduced so far, each of them with unique features. AIMS: To analyze our first real-world experience with the second- generation, mechanically expanded, fully repositionable transfemoral Lotus TAVR device (Boston Scientific)...
November 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27816175/-transfemoral-tavi-procedure-in-women-minimally-invasive-technique
#7
H Benamer, B Chevalier, A Roy, M A Bouzid, C Perdrix, P Garot, T Hovasse, T Unterseeh, S Champagne, T Lefèvre
Demographic data point to a substantial proportion of women in the population of elderly patients with an increasing prevalence of aortic stenosis. Implantation of an aortic bioprosthesis via an endovascular approach known as Transcatheter aortic valve implantation (TAVI) in patients presenting with a symptomatic tight aortic stenosis (severe aortic stenosis) (AS) is an alternative therapeutic option to surgical aortic valve replacement in patients at high surgical risk or ineligible for surgery. The literature has shown that this technique seems to be particularly beneficial in female patients...
November 2, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27813144/arterio-venous-fistula-for-automated-red-blood-cells-exchange-in-patients-with-sickle-cell-disease-complications-and-outcomes
#8
Marianne Delville, Sandra Manceau, Nassim Ait Abdallah, Jan Stolba, Sameh Awad, Thibaud Damy, Barnabas Gellen, Laurent Sabbah, Karima Debbache, Vincent Audard, Jean-Louis Beaumont, Cécile Arnaud, Christelle Chantalat-Auger, Françoise Driss, François Lefrère, Marina Cavazzana, Franco Gilbert, Frederic Galacteros, Jean-Antoine Ribeil, Justine Gellen-Dautremer
Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French sickle cell disease reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected...
November 4, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27795630/high-hemodialysis-vascular-access-flow-and-impaired-right-ventricular-function-in-chronic-hemodialysis-patients
#9
S Yilmaz, M Yetim, B K Yilmaz, T Dogan, E Aksoy, N Yuksel, I Dogan
There are limited data showing right ventricular preload increase due to high-flow arteriovenous fistulas (AVFs). This cross-sectional study investigated whether high AVF flow had an impact on right ventricular function in patients undergoing hemodialysis. Sixty-four patients aged between 18 and 85 years who were on routine hemodialysis with >2 hemodialysis sessions per week for at least 3 months via an AVF were studied. Patients with inadequate flow fistulas, severe chronic obstructive pulmonary disease, history of pulmonary embolism, primary pulmonary hypertension, severe mitral, aortic or pulmonary regurgitation, and/or stenosis were excluded...
September 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27791257/assessing-radiocephalic-wrist-arteriovenous-fistulas-of-obtuse-anastomosis-using-computational-fluid-dynamics-and-clinical-application
#10
Jinkee Lee, Sunho Kim, Sung-Min Kim, Ryungeun Song, Hyun Kyu Kim, Jang Sang Park, Sun Cheol Park
INTRODUCTION: A radiocephalic arteriovenous fistula (AVF) is the best choice for achieving vascular access (VA) for hemodialysis, but this AVF has high rates of early failure due to juxta-anastomotic stenosis, making it impossible to use for dialysis. Low hemodynamic shear stress contributes to the pathophysiology of VA failure due to secondary thrombosis, stenosis, and re-occlusion after percutaneous intervention. METHODS: We used a computational fluid dynamics (CFDs) approach to evaluate the shear stress distribution and minimize its effects under various conditions including changes in the anastomosis angle...
November 2, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27774967/trans-subclavian-aortic-valve-replacement-with-various-bioprosthetic-valves-single-center-experience
#11
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27736852/rapid-access-carotid-endarterectomy-winning-the-race-following-a-natural-disaster
#12
Manar Khashram, Rachel Falconer, Afif Mahmud, Adib Khanafer, Peter Laws, Tim Beresford, Justin Roake
AIMS: Rapid access carotid endarterectomy (RACE) is the gold standard for stroke prevention in symptomatic patients with 50-99% internal carotid artery stenosis. Diagnosis and referral of eligible patients may be delayed by disruption to local health services. The aim of this study was to evaluate whether service provision was maintained at an appropriate standard (<2 weeks) following a natural disaster. METHODS: Consecutive symptomatic patients who underwent carotid endarterectomy (CEA) at a tertiary hospital between January 2006 and December 2014 were identified...
October 14, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27716892/duplex-ultrasound-for-the-prediction-of-vascular-events-associated-with-arteriovenous-fistulas-in-hemodialysis-patients
#13
Takeo Ishii, Yasunobu Suzuki, Takuji Nakayama, Miki Ohmori, Shinichi Masai, Naru Sasagawa, Kunio Ohyama
OBJECTIVE: To determine if duplex ultrasound (US) for arteriovenous fistulas (AVFs) can predict vascular events (VEs; thrombosis and stenosis). METHODS: Duplex US was performed for vascular access evaluation in 2557 maintenance hemodialysis (HD) patients between October 1, 2013 and March 31, 2016. Of these patients, 2184 patients were finally included in this study. AVF dysfunction was assessed using the brachial artery blood flow volume (Qa; mL/min), arterial blood flow resistance index (RI), and residual diameter of the fistula vein (RD; mm)...
September 27, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27716891/does-pre-and-post-angioplasty-doppler-ultrasound-evaluation-help-in-predicting-vascular-access-outcome
#14
Maria Guedes-Marques, Pedro A Maia, Fernando Neves, Aníbal Ferreira, João Cruz, Dulce Carvalho, Carlos Oliveira, Carlos Barreto, Telmo Carvalho, Pedro Ponce
BACKGROUND: Kidney Disease - Improving Global Outcomes (KDIGO) recommends post-percutaneous transluminal angioplasty (PTA) <30% residual stenosis (RS) and hemodynamic parameters improvement. Primary end point: how post-PTA access blood flow (ABF) improvement predicts vascular access (VA) outcome. Secondary: compare Doppler ultrasound (DU) and angiography diagnostic accuracy; determine how other factors predict outcome. METHODS: Eighty patients. DU evaluation performed pre- and post-PTA...
September 24, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27696659/transcatheter-aortic-valve-implantation-with-a-sapien-3-commander-20-mm-valves-in-patients-with-degenerated-19-mm-bioprosthetic-aortic-valve
#15
Pranav Loyalka, Angelo Nascimbene, Michael Schechter, Marija Petrovic, Ajay Sundara Raman, Igor D Gregoric, Biswajit Kar
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic aortic valve has been successfully performed as an alternative to surgery. We describe our initial experience of valve-in-valve TAVI in five patients, using new generation Edwards Sapien 3 transcatheter heart valves implanted into degenerated 19 mm bioprosthetic valves. 20-mm Edwards S3 valves were offered for compassionate use. All patients had significant aortic valve stenosis. METHODS AND RESULTS: The main vascular access was achieved and pre-closed with two Proglide closure devices in one patient and Prostar closure devices in four patients...
October 3, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27682594/long-term-outcome-after-application-of-the-angio-seal-vascular-closure-device-in-minipigs
#16
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
https://www.readbyqxmd.com/read/27669543/impact-of-vascular-access-intervention-therapy-on-cardiac-load-in-hemodialysis-patients
#17
Takayuki Adachi, Tsutomu Sakurada, Takanori Otowa, Keita Uehara, Shina Sueki, Shigeki Kojima, Nagayuki Kaneshiro, Katsuomi Matsui, Tadahisa Tomohiro, Yugo Shibagaki
Vascular access intervention therapy (VAIVT) has been positioned as the first choice of treatment for stenosis lesions frequently observed in arteriovenous fistula (AVF) for hemodialysis patients in Japan. Furthermore, increased blood flow can provide a stable dialysis. In contrast, it has been reported that excess blood flow of AVF causes high-output heart failure. Although VAIVT is used to increase blood flow of AVF, the impact of VAIVT on cardiac load has been rarely reported. We examined the factors associated with cardiac load in hemodialysis patients undergoing VAIVT by measuring levels of α human atrial natriuretic polypeptide (hANP) and brain natriuretic peptide (BNP) before and after VAIVT...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27665337/-balloon-valvuloplasty-for-aortic-stenosis-using-umbilical-vein-access-in-a-newborn-first-experience-in-turkey
#18
Kemal Nişli, Serra Karaca, Aygün Dindar
Balloon valvuloplasty is an effective therapy for severe congenital aortic valve stenosis, with mild aortic insufficiency and minimal intermediate-term restenosis. No consensus currently exists regarding optimal vascular approach for balloon dilatation in newborns with critical or severe aortic valve stenosis. Critical aortic valve stenosis in newborns must be treated promptly and effectively. Transcatheter therapy may offer marked advantages, as surgical therapy has been associated with significant rates of morbidity and mortality...
September 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27609256/transcatheter-aortic-valve-replacement-using-transaortic-access-experience-from%C3%A2-the-multicenter-multinational-prospective-route-registry
#19
Vinayak Bapat, Derk Frank, Ricardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Peter Bramlage, Cornelia Deutsch, Martin Thoenes, Mauro Romano
OBJECTIVES: The Registry of the Utilization of the TAo-TAVR approach using the Edwards SAPIEN Valve (ROUTE) was established to assess the effectiveness and safety of the use of transaortic (TAo) access for transcatheter aortic valve replacement (TAVR) procedures (NCT01991431). BACKGROUND: TAVR represents an alternative to surgical valve replacement in high-risk patients. Whereas the transfemoral access route is used commonly as the first-line approach, transapical access is an option for patients not suitable for transfemoral treatment mainly due to anatomic conditions...
September 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27601144/usefulness-of-paclitaxel-releasing-high-pressure-balloon-associated-with-cutting-balloon-angioplasty-for-treatment-of-outflow-stenoses-of-failing-hemodialysis-arteriovenous-shunts
#20
Anna Maria Ierardi, Marco Franchin, Federico Fontana, Gabriele Piffaretti, Ejona Duka, Massimo Tonolini, Vittorio Miele, Matteo Tozzi, Gianpaolo Carrafiello
AIM: To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt. MATERIAL AND METHODS: From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography...
September 6, 2016: La Radiologia Medica
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