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https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#1
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28721509/maintaining-patency-of-vascular-access-for-haemodialysis
#2
Nicholas Inston, J Al Shakarchi, A Khawaja, R Jones
All types of vascular access, a necessity for haemodialysis, are prone to thrombosis and if untreated this results in failure. Thrombosis results from the combination of impaired blood flow, endothelial and vessel wall injury and a propensity towards pro-coagulative states, either intrinsic or aggravated by dialysis or dehydration. The treatment of access thrombosis relies on removal of the clot (thrombectomy) and treatment of the underlying problem. In most cases this is stenosis secondary to neointimal hyperplasia which can occur early (failure to mature) or later...
July 18, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28706886/the-effects-of-indoxyl-sulfate-induced-endothelial-microparticles-on-neointimal-hyperplasia-formation-in-an-ex-vivo-model
#3
Jung-Hwa Ryu, HeeJung Park, Seung-Jung Kim
PURPOSE: Neointimal hyperplasia (NH) is considered to be one of the main causes of vascular access occlusion in patients receiving hemodialysis. Endothelial injury and TGF-β-mediated proliferation of vascular smooth muscle cells (VSMCs) induce NH. Endothelial microparticles (EMPs) are also increased by endothelial injury. We aimed to investigate the effects of EMPs and TGF-β expression on VSMC proliferation and their contributions to NH formation in an ex vivo model. METHODS: EMPs were collected from the culture media of human umbilical vein endothelial cells treated with indoxyl sulfate (IS, 250 µg/mL) after ultracentrifugation at 100,000 × g...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#4
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28685192/venous-thrombosis-and-stenosis-after-peripherally-inserted-central-catheter-placement-in-children
#5
H Stella Shin, Alexander J Towbin, Bin Zhang, Neil D Johnson, Stuart L Goldstein
BACKGROUND: Peripherally inserted central catheters (PICCs) can lead to development of venous thrombosis and/or stenosis. The presence of venous thrombosis and/or stenosis may preclude children with chronic medical conditions from receiving lifesaving therapies, from hemodialysis in end-stage renal disease to total parenteral nutrition in short bowel syndrome. Several adult studies have found an association between PICCs and venous thrombosis and/or stenosis, but none has evaluated for this association in children...
July 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28683542/feasibility-and-applicability-of-static-vascular-outline-roadmapping-during-tavi
#6
Navid Madershahian, Carolyn Weber, Payman Majd, Tanja Rudolph, Elmar Kuhn, Maximilian Scherner, Yeong-Hoon Choi, Kaveh Eghbalzadeh, Volker Rudolph, Cherif Sahyoun, Thorsten Wahlers
BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips "Vascular Outlining" prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two- dimensional vessel margins as a roadmap on live fluoroscopy...
July 5, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28682324/matching-patients-with-the-ever-expanding-range-of-tavi-devices
#7
REVIEW
Brandon M Jones, Amar Krishnaswamy, E Murat Tuzcu, Stephanie Mick, Wael A Jaber, Lars G Svensson, Samir R Kapadia
Transcatheter aortic valve implantation (TAVI) has become a widely accepted strategy for the treatment of aortic stenosis in patients at intermediate, high, or prohibitive surgical risk. After >1 decade of innovation and clinical trial experience, the available technology for TAVI has grown enormously, and now includes a myriad of vascular access approaches and innovative valve designs. As a result, the range of patients who can benefit from these advances continues to grow rapidly. Furthermore, given the improved safety profile and clinical success of current-generation devices in randomized trials, the use of TAVI among even low-risk populations is justified in current trials...
July 6, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28666501/spontaneous-rupture-and-dissection-of-aspergillus-infected-arteriovenous-fistula
#8
Syed Nayer Mahmud, Behzad Kaleem Baloch, Muhammed Safdar, Muhammed Saeed
Patients with end stage renal disease need a vascular access like arteriovenous (AV) fistula, AV graft or central venous catheter for hemodialysis. However, AV fistula can be complicated due to infection, stenosis, ulceration etc. Among these, spontaneous rupture of AV fistula is rare and can be due to stenosis or infection. Fungal infection of AV fistula is very rare and the most common organism involved is Candida. Infection of native AV fistula with Aspergillusis not reported in the literature. This case discusses the spontaneous rupture and dissection of an Aspergillusinfected arteriovenous fistula, requiring urgent closure and repairing of vessel...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28665461/clinical-predictors-of-recurrent-stenosis-and-need-for-re-intervention-in-the-cephalic-arch-in-patients-with-brachiocephalic-av-fistulas
#9
Saravanan Balamuthusamy, Alagarsamy Lakku Reddi, Machaiah H Madhrira, Balamurugan Sankarapandian, Peter Nguyen, Avinash Vallurupalli, William Gabbard, Nishant Jalandhara, Albert Yurvati
INTRODUCTION: Cephalic arch stenosis is one of the most common reasons for repeated endovascular intervention and eventual abandonment of access in hemodialysis patients. There is no prediction model to identify risk factors for recurrent cephalic arch stenosis. We have developed a mathematical model to predict the need for reintervention in brachiocephalic (BC) fistulas with recurrent cephalic arch stenosis. METHODS: Single-center retrospective analysis of 143 patients with a BC fistula referred to the vascular clinic for access dysfunction who underwent cephalic arch angioplasty were included for the analysis...
June 23, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28660560/jetstream-atherectomy-and-balloon-angioplasty-with-distal-embolic-protection-for-angio-seal%C3%A2-related-vascular-access-complications
#10
Mihir Barvalia, Mohammad Thawabi, Yassir Nawaz, Nishant Sethi, John Shao, Michael Amponsah, Gautam Visveswaran, Marc Cohen, Najam Wasty
Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases...
June 28, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28655388/ultrasound-guided-percutaneous-endovascular-treatment-of-arteriovenous-fistula-graft
#11
Boštjan Leskovar, Tjaša Furlan, Simona Poznič, Maja Potisek, Anton Adamlje, Tomaž Ključevšek
BACKGROUND: Ultrasound-guided percutaneous endovascular treatment of arteriovenous fistula (AVF) or graft failure is an alternative to radiologically-guided angioplastic methods. Its main advantages are that it can be used with open or percutaneous access, using no contrast media and no radiation. The aim of this study was to analyze the results of ultrasound-guided endovascular treatment of arteriovenous access failure. MATERIAL AND METHODS: Preoperative ultrasound was used to determine the degree of stenosis and the size of balloon used in angioplasty...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28649146/a-predictive-framework-to-elucidate-venous-stenosis-cfd-shape-optimization
#12
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Mary Hammes, Fredric Coe
The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency...
July 1, 2017: Computer Methods in Applied Mechanics and Engineering
https://www.readbyqxmd.com/read/28647193/cryopreserved-venous-allograft-is-an-acceptable-conduit-in-patients-with-current-or-prior-angioaccess-graft-infection
#13
Michael P Harlander-Locke, Peter F Lawrence, Aamna Ali, Esther Bae, James Kohn, Christopher Abularrage, Michael Ricci, Gary W Lemmon, Sotero Peralta, Jeffrey Hsu
OBJECTIVE: The durability of cryopreserved allograft has been previously demonstrated in the setting of infection. The objective of this study was to examine the safety, efficacy, patency, and cost per day of graft patency associated with using cryopreserved allograft (vein and artery) for hemodialysis access in patients with no autogenous tissue for native fistula creation and with arteriovenous graft infection or in patients at high risk for infection. METHODS: Patients implanted with cryopreserved allograft for hemodialysis access between January 2004 and January 2014 were reviewed using a standardized, multi-institutional database that evaluated demographic, comorbidity, procedural, and outcomes data...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28616344/vascular-approaches-for-transcatheter-aortic-valve-implantation
#14
REVIEW
Isaac Pascual, Amelia Carro, Pablo Avanzas, Daniel Hernández-Vaquero, Rocío Díaz, Jose Rozado, Rebeca Lorca, María Martín, Jacobo Silva, César Morís
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving therapeutic modality currently available for patients with severe aortic stenosis (AS) that are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk. Transfemoral approach is the preferred TAVI delivery route when possible. Alternative non-transfemoral access options include transaortic, trans-subclavian and transapical access. Other approaches are also feasible (transcarotid, transcaval, and antegrade aortic) but are restricted to operators and hospitals with experience...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28606889/parallel-suture-technique-with-proglide-a-novel-method-for-management-of-vascular-access-during-transcatheter-aortic-valve-implantation-tavi
#15
Ilka Ott, Anupama Shivaraju, Nina R Schäffer, Antonio H Frangieh, Jonathan Michel, Oliver Husser, Christian Hengstenberg, Patrick Mayr, Roisin Colleran, Constanza Pellegrini, Salvatore Cassese, Massimilliano Fusaro, Heribert Schunkert, Adnan Kastrati, Albert M Kasel
AIMS: Aim of this study was to evaluate vascular complications using the "parallel suture technique" in patients receiving Edwards SAPIEN XT (SXT) or SAPIEN S3 (S3) transcatheter heart valve (THV). METHODS AND RESULTS: Two hundred consecutive patients with symptomatic severe aortic stenosis treated with TF-TAVI were included in this study where the "parallel suture technique" was applied for vascular access site closure. This was achieved by placing the sutures medial and lateral to the puncture site...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28597797/percutaneous-intervention-for-central-shunts-new-routes-new-strategies
#16
Bjorn Cools, Stephen C Brown, Derize E Boshoff, Benedicte Eyskens, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
Introduction In traditional locations, the standard Blalock-Taussig shunt presents numerous technical difficulties for percutaneous intervention. We changed our strategy to a central type shunt (Laks-type) with end-to-side pulmonary and side-to-side aortic anastomosis. The aim of this study was to determine whether this modified strategy would allow easier percutaneous manipulation in patients with small pulmonary arteries. Methods All children with a stretchable central vascular graft who required any form of percutaneous intervention were prospectively enrolled in the study...
April 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28583682/outcome-of-stent-graft-implantation-for-treatment-of-access-site-bleeding-after-transfemoral-transcatheter-aortic-valve-replacement
#17
Adi Segal, Moshe Y Flugelman, Nader Khader, Ronen Rubinshtein, Idit Lavi, Ron Karmeli, Ayman Jubran, Avinoam Shiran, Ronen Jaffe
Vascular complications are common after transcatheter aortic valve replacement (TAVR) and are associated with increased morbidity and mortality. Stent graft implantation enables percutaneous treatment of access site bleeding; however, the efficacy and durability and of this approach are unknown. We studied the immediate outcome of stent graft implantation for control of access site bleeding and the need for repeat vascular interventions after stenting, in a cohort of consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28582580/transaortic-transcatheter-aortic-valve-implantation-using-sapien-xt-or-sapien-3-valves-in-the-route-registry%C3%A2
#18
Mauro Romano, Derk Frank, Riccardo 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, Cornelia Deutsch, Peter Bramlage, Martin Thoenes, Vinayak Bapat
OBJECTIVES: Transaortic (TAo) access for transcatheter aortic valve implantation (TAVI) is an alternative to the conventional transfemoral or transapical routes. Data comparing the characteristics and outcomes of TAo-TAVI using the SAPIEN XT and SAPIEN 3 heart valves are scarce. The objective of the current analysis was to provide such information. METHODS: ROUTE is an international, prospective, observational registry. Patients with severe calcific aortic stenosis scheduled for TAo-TAVI with an Edwards SAPIEN XT or a SAPIEN 3 heart valve were consecutively enrolled at 22 centres across Europe between February 2013 and February 2015...
June 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28560568/outcome-of-carotid-artery-stenting-in-the-hands-of-vascular-surgeons
#19
Carola Marie Wieker, S Demirel, N Attigah, M Hakimi, U Hinz, D Böckler
OBJECTIVES: To analyze the procedural and clinical outcomes of carotid artery stenting (CAS) in the hands of endovascular trained vascular surgeons. METHODS: Between April 2008 to May 2013, 1197 patients were treated for extracranial internal carotid artery (ICA) stenosis. The proportion of endovascular treated patients was 5.0% (CAS n = 60 vs. carotid endarterectomy (CEA) n = 1137). All patients in the CAS group (44 males, median age 70 years) were treated by two senior vascular surgeons experienced in endovascular methods...
August 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28559093/the-lutonix%C3%A2-drug-coated-balloon-a-novel-drug-delivery-technology-for-the-treatment-of-vascular-disease
#20
REVIEW
Ian Schorn, Harrison Malinoff, Steven Anderson, Cyal Lecy, Jeffrey Wang, Joseph Giorgianni, George Papandreou
Local drug delivery of an anti-proliferative drug from balloon catheter systems to the site of arterial injury has been attempted repeatedly over the years with limited success in drug uptake and retention. Accessibility of the drug at the site is critical to combat the body's response to the procedural trauma of angioplasty. Recently, formulations have been designed which achieve delivery of therapeutic doses of the anti-proliferative drug paclitaxel to arteries with higher efficiency and longer tissue retention...
March 2017: Advanced Drug Delivery Reviews
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