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Vascular access stenosis

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https://www.readbyqxmd.com/read/29211872/misplacement-of-stent-into-epidural-venous-plexus-with-resultant-cauda-equina-syndrome-and-open-surgical-treatment-a-case-report
#1
Benjamin B Whiting, Celene B Mulholland, Lorin Daniels, U Kumar Kakarla, Nicholas Theodore, Laura A Snyder
BACKGROUND AND IMPORTANCE: Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression...
December 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29178510/the-pathogenesis-of-hemodialysis-vascular-access-failure-and-systemic-therapies-for-its-prevention-optimism-unfulfilled
#2
REVIEW
Andrea K Viecelli, Trevor A Mori, Prabir Roy-Chaudhury, Kevan R Polkinghorne, Carmel M Hawley, David W Johnson, Elaine M Pascoe, Ashley B Irish
In patients receiving hemodialysis, the provision of safe and effective vascular access using an arteriovenous fistula or graft is regarded as a critical priority by patients and health professionals. Vascular access failure is associated with morbidity and mortality, such that strategies to prevent these outcomes are essential. Inadequate vascular remodeling and neointimal hyperplasia resulting in stenosis and frequently thrombosis are critical to the pathogenesis of access failure. Systemic medical therapies with pleiotropic effects including antiplatelet agents, omega-3 polyunsaturated fatty acids (fish oils), statins, and inhibitors of the renin-angiotensin-aldosterone system (RAAS) may reduce vascular access failure by promoting vascular access maturation and reducing stenosis and thrombosis through antiproliferative, antiaggregatory, anti-inflammatory and vasodilatory effects...
November 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29153460/real-world-procedural-and-30-day-outcome-using-the-portico-transcatheter-aortic-valve-prosthesis-a-large-single-center-cohort
#3
Andrea Denegri, Fabian Nietlispach, Jan Kottwitz, Gabor Suetsch, Philipp Haager, Hector Rodriguez, Maurizio Taramasso, Slayman Obeid, Francesco Maisano
BACKGROUND: Published procedural and short-term outcome of the Portico valve for Transcatheter Aortic Valve Implantation (TAVI) is limited. We report a single-center patient series assessing procedural and 30-day outcome of this device. METHODS AND RESULTS: Procedural and 30-day follow-up data were prospectively collected from a consecutive series of 73 patients (80.7±6.9years, 45% male, mean STS score: 4.8±3.9) with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI)...
November 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29131296/complete-percutaneous-approach-versus-surgical-access-in-transfemoral-transcatheter-aortic-valve-implantation-results-from-a-multicenter-registry
#4
Janusz Kochman, Łukasz Kołtowski, Zenon Huczek, Bartosz Rymuza, Radosław Wilimski, Maciej Dąbrowski, Adam Witkowski, Marek Grygier, Anna Olasińska-Wiśniewska, Piotr Kubler, Krzysztof Reczuch, Radosław Parma, Andrzej Ochała, Dariusz Jagielak, Wacław Kochman, Eberhard Grube
BACKGROUND: Although the femoral approach is the most common route utilized in transcatheter aortic valve implantation (TAVI) it still carries a substantial risk of severe bleeding and vascular complications. The aim of our study was to compare the safety and efficacy of the complete percutaneous (CPC) approach with surgical cutdown and closure (SCC) in TAVI patients. METHODS: The study population comprised 683 patients with severe aortic stenosis who underwent transfemoral TAVI...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29130619/a-feasibility-study-of-transaxillary-tavi-with-the-lotus-valve
#5
Sagar N Doshi, Sudhakar George, Chun Shing Kwok, Anthony Mechery, Mamas Mamas, Peter F Ludman, Jonathan N Townend, Moninder Bhabra
OBJECTIVES: To assess the feasibility of axillary transcatheter aortic valve implantation (TAVI) using the Lotus valve. BACKGROUND: TAVI is used to treat patients with severe aortic stenosis, with transfemoral (TF) access being the safest and most widely used route. In patients unsuitable for this, there are reports that the axillary artery may be safest alternative access route. The Lotus device is a fully retrievable 2nd generation transcatheter heart valve which is licensed for femoral and transaortic access...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#6
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105493/a-7-year-single-center-experience-of-transfemoral-tavi-evolution-of-surgical-activity-and-impact-on-vascular-outcome
#7
Fabien Lareyre, Juliette Raffort, Carine Dommerc, Yacoub Habib, François Bourlon, Claude Mialhe
Transcatheter aortic valve implantation (TAVI) has become a well-established alternative to open surgery to treat aortic stenosis. We describe our 7-year TAVI experience using transfemoral access and identity changes in surgical activity and evaluate its impact on postoperative vascular outcomes. Consecutive patients (N = 340) who underwent TAVI with percutaneous transfemoral access were retrospectively included and divided into 4 quartiles according to the date of intervention. Vascular outcomes were classified according to the Valve Academic Research Consortium 2 classification...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29104939/asymmetric-dimethylarginine-does-not-predict-early-access-events-in-hemodialysis-patients-with-brachiocephalic-fistula-access
#8
Mary Hammes, Rita McGill, Promila Dhar, Rama S Madhurapantula
Background: Vascular access for hemodialysis is best provided by an arteriovenous fistula (AVF). AVF fail primarily because of neointimal hyperplasia. Asymmetric dimethlyarginine (ADMA) is a naturally occurring analogue of L-arginine, which is elevated in renal failure and impairs endothelial cell function. ADMA inhibits nitric oxide synthetase, leading to impaired nitric oxide production and contributing to the development of neointimal hyperplasia. ADMA was measured at the time of AVF placement to evaluate associations with access failure...
August 2017: International Journal of Nephrology and Kidney Failure
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria-%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#9
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29099536/aneurysms-in-vascular-access-state-of-the-art-and-future-developments
#10
Nicholas Inston, Hiren Mistry, James Gilbert, David Kingsmore, Zahid Raza, Matteo Tozzi, Ali Azizzadeh, Robert Jones, Colin Deane, Jason Wilkins, Ingemar Davidson, John Ross, Paul Gibbs, Dean Huang, Domenico Valenti
A master class was held at the Vascular Access at Charing Cross (VA@CX2017) conference in April 2017 with invited experts and active audience participation to discuss arteriovenous (AV) vascular access aneurysms, a serious and common complication of vascular access (VA). The natural history of aneurysms in VA is poorly defined, and although classifications exist they are not uniformly applied in studies or clinical practice. True and pseudo aneurysms of AV access occur. Whilst an AV fistula by definition is an abnormal dilatation of a blood vessel, an agreed definition of 18 mm, or 3 times accepted maturation diameter, is proposed...
November 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29080304/high-resolution-computational-fluid-dynamic-simulation-of-haemodialysis-cannulation-in-a-patient-specific-arteriovenous-fistula
#11
David Fulker, Bogdan Ene-Iordache, Tracie J Barber
Arteriovenous fistulae are the preferred choice of vascular access in hemodialysis patients, however complications such as stenosis can lead to access failure or recirculation, which reduces dialysis efficiency. This study utilized computational fluid dynamics on a patient specific radio-cephalic fistula under hemodialysis treatment to determine the dynamics of access recirculation and identify the presence of disturbed flow. Metrics of transverse wall shear stress and oscillatory shear index were used to characterize the disturbed flow acting on the blood vessel wall, whilst a power spectral density analysis was used to calculate the any turbulence within the access...
October 28, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29068124/percutaneous-transcatheter-aortic-valve-replacement-induces-femoral-artery-shrinkage-angiographic-evidence-and-predictors-for-a-new-side-effect
#12
Osama Shoeib, Francesco Burzotta, Cristina Aurigemma, Lazzaro Paraggio, Fausta Viccaro, Italo Porto, Antonio Maria Leone, Piergiorgio Bruno, Carlo Trani
OBJECTIVES: We sought to investigate the possible impact of transaortic valve replacement (TAVR) on common femoral artery (CFA) integrity as assessed by angiography. BACKGROUND: CFA represents the most adopted access for TAVR but various degrees of vascular damage may be induced by the procedure. METHODS: Patients underwent percutaneous transfemoral TAVR who had both pre- and post-TAVR access-site angiography were retrospectively selected...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29062822/stand-alone-anterior-lumbar-interbody-fusion-complications-and-perioperative-results
#13
Rodrigo Amaral, Ronaldo Ferreira, Luis Marchi, Rubens Jensen, Joes Nogueira-Neto, Luiz Pimenta
OBJECTIVES: Historically, anterior lumbar interbody fusion (ALIF) was related to high rates of intraoperative complications and adverse events related to interbody devices. In recent decades, there have been technical adjustments, and cages that are more suitable have emerged. The aim of this study is to evaluate the efficacy and complication rate of the use of stand-alone mini-ALIF using a self-locking cage. METHODS: Retrospective single center study. Inclusion criteria: retroperitoneal mini-ALIF for single-level fusion (L5S1); self-locking cage; DDD/stenosis and grade I spondylolisthesis...
September 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29062749/transcatheter-aortic-valve-implantation-in-nonagenarians-selectively-feasible-or-extravagantly-futile
#14
Antonis S Manolis, Antonis A Manolis
A growing number of nonagenarians is recorded as life expectancy increases. Unfortunately, this extreme-aged group is plagued by increased prevalence of aortic stenosis amidst a higher occurrence of comorbidities that pose dilemmas to cardiologists and cardiac surgeons when having to choose a conservative or interventional treatment modality, and a surgical or transcatheter aortic valve implantation (TAVI) approach. TAVI is an expensive procedure, which also confers a higher mortality and morbidity risk in nonagenarians, compared to younger patients...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062745/review-of-minimal-access-versus-transcatheter-aortic-valve-replacement-for-patients-with-severe-aortic-stenosis
#15
Carson T Hoffmann, Jacob A Heiner, Tom C Nguyen
Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (miniAVR) have become alternatives to surgical aortic valve replacement via median sternotomy (SAVR) to treat severe aortic stenosis (AS). Despite increased interest and utilization, few studies have directly compared TAVR and miniAVR. A review of the current literature shows TAVR to be an indispensable tool for inoperable, high-risk, and perhaps intermediate-risk patients with severe AS. However, it is associated with a number of deleterious perioperative outcomes, such as valvular regurgitation and vascular complications...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29057349/clinical-evaluation-of-microendoscopy-assisted-extreme-lateral-interbody-fusion
#16
Tomohide Segawa, Hirohiko Inanami, Hisashi Koga
BACKGROUND: Extreme lateral interbody fusion (XLIF) has rapidly become a popular operative procedure for lumbar canal stenosis and scoliosis. This approach provides direct access to the lateral aspect of the disc with minimal disruption of spinal structures, including ligaments and muscles. However, it involves risk of injuries to the lumbar nerve plexus, segmental artery and intestinal tract because of the limited surgical field. This study aimed to clarify the benefit of using a microendoscope to prevent these injuries...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29048474/transinnominate-approach-for-transcatheter-aortic-valve-replacement-single-centre-experience-of-minimally-invasive-alternative-access
#17
Luigi Pirelli, Jacob S Scheinerman, Derek R Brinster, Nirav C Patel, Alaeldin Eltom, Jonathan M Hemli, Chad A Kliger
OBJECTIVES: Iliofemoral arteries have been the preferred access for transcatheter aortic valve replacement (TAVR). When these arteries are too small, calcified or tortuous, an alternative access must be considered. Transinnominate (TI) access is an extrathoracic approach that does not require manipulation of major neurovascular structures or the apex. The aim of this study is to evaluate the efficacy and safety of TI TAVR as an alternative access in patients with severe aortic stenosis not amenable to a transfemoral approach...
October 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29033504/procedural-characteristics-and-outcomes-of-transcatheter-aortic-valve-implantation-a-single-center-experience-of-the-first-100-inoperable-or-high-surgical-risk-patients-with-severe-aortic-stenosis
#18
Ying-Hwa Chen, Hsiao-Huang Chang, Po-Lin Chen, Zen-Chung Weng, I-Ming Chen, Hsin-Bang Leu, Chun-Yang Huang, Su-Man Lin, Mei-Han Wu
BACKGROUND: This is the first study of a Taiwanese population reporting transcatheter aortic valve implantation (TAVI) outcomes of the first 100 cases from a single center offering two different transcatheter heart valve technologies via six types of approaches. We herein report the 30-day and one-year outcomes in our first 100 TAVI patients at Taipei Veterans General Hospital. METHODS: From May 2010 to April 2016, 100 consecutive patients with severe aortic stenosis (AS) who were considered unsuitable or at high risk for surgical aortic valve replacement underwent TAVI...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29024382/comparison-of-outcomes-with-surgical-cut-down-versus-percutaneous-transfemoral-transcatheter-aortic-valve-replacement-tavr-transfemoral-access-comparisons-between-surgical-cut-down-and-percutaneous-approach
#19
Brandon C Drafts, Charles H Choi, Kunal Sangal, Michael W Cammarata, Robert J Applegate, Sanjay K Gandhi, Edward H Kincaid, Neal Kon, David X Zhao
OBJECTIVES: The objective is to compare the short-term (30 days) and late (12 months) vascular adverse events in patients undergoing transfemoral (TF)-transcatheter aortic valve replacement (TAVR) by surgical cut-down (SC) vs. percutaneous (PC) approaches. BACKGROUND: Programs continue to utilize both approaches in TF-TAVR. There are limited data comparing outcomes by SC vs. PC approaches and long-term effects of endovascular intervention facilitated hemostasis on late vascular adverse events...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28977565/transcarotid-transcatheter-aortic-valve-implantation-multicentre-experience-in-france
#20
Thierry Folliguet, Nicolas Laurent, Maxime Bertram, Konstantinos Zannis, Mazen Elfarra, Fabrice Vanhuyse, Pablo Maureira, Thomas Modine
OBJECTIVES: Transcatheter aortic valve implantation is a well-recognized treatment option for high-risk patients with aortic stenosis. The femoral approach is possible in 80% of cases and remains the access of choice. When this approach is not feasible, other alternative routes have been proposed such as transapical, transaortic and subclavian. Transcarotid aortic valve implantation has been proposed as another direct vascular access. Its use is relatively new and still under evaluation...
August 4, 2017: European Journal of Cardio-thoracic Surgery
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