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Vascular access stenosis

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https://www.readbyqxmd.com/read/29662315/pitfalls-in-the-ankle-brachial-index-and-brachial-ankle-pulse-wave-velocity
#1
Dai Ato
Background: The ankle-brachial index (ABI) and pulse wave velocity (PWV) are indices of atherosclerosis and arterial stiffness. The Japan-made measuring devices of those indices have spread widely because of their convenience and the significance of the parameters. However, studies that comprehensively discuss the various pitfalls in using these indices are not available. Methods: This study presents several representative pitfalls in using the ABI and brachial-ankle PWV (baPWV) by showing the result sheets of the device, "the Vascular Profiler"...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29642730/long-term-outcomes-of-bovine-pericardial-patch-angioplasty-for-recurrent-stenosis-in-vascular-access-a-uk-single-centre-experience
#2
Owain Fisher, Lewis Meecham, Pauline Buxton, Jocelyn Legge, Jack Fairhead, Sriram Rajagopalan, John Asquith, Arun Pherwani
INTRODUCTION: Stenosis of an arteriovenous fistula or arteriovenous graft for dialysis is a common problem. Stenosis may lead to a number of problems including failure of the fistula. Treatment of stenosis is commonly with percutaneous angioplasty or surgical patch angioplasty with autologous vein or synthetic graft or patch. Here we report the use of bovine pericardial patch angioplasty as an alternative mode of patch angioplasty when percutaneous intervention has failed. METHODS: Patients with fistulae treated with bovine patch angioplasty between 2013 and 2016 were identified from a prospectively maintained renal access database (Cyberren® )...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29627998/physical-examination-of-the-hemodialysis-arteriovenous-fistula-to-detect-early-dysfunction
#3
Kenneth Abreo, Bakhtiar M Amin, Adrian P Abreo
The maintenance of vascular access patency for end-stage renal disease patients on hemodialysis is necessary for survival. Many nephrologists, nurse practitioners, and nurses have limited experience with the physical examination of the arteriovenous fistula. In this review, we define key terms used in the assessment of an arteriovenous fistula. We discuss the arteriovenous fistula physical exam, including details of inspection, palpation, and auscultation. Using these concepts, we review the abnormal findings that can assist practitioners in determining the location of a stenosis...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29622355/a-prospective-randomized-study-of-stent-graft-placement-after-balloon-angioplasty-versus-balloon-angioplasty-alone-for-the-treatment-of-hemodialysis-patients-with-prosthetic-graft-outflow-stenosis
#4
Hsuan-Tzu Yang, Sheng-Yueh Yu, Ta-Wei Su, Tsung-Chi Kao, Hung-Chang Hsieh, Po-Jen Ko
BACKGROUND: Hemodialysis graft outflow stenosis is a significant complication occurring in hemodialysis patients with prosthetic grafts for vascular access. Balloon angioplasty remains the first-line endovascular treatment of this complication, although covered stent graft implantation after balloon angioplasty also appears to be an effective and promising treatment. The aim of this study was to evaluate the efficacy and durability of stent graft placement after balloon angioplasty in comparison to balloon angioplasty alone for the treatment of graft outflow stenosis in hemodialysis patients...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29618072/surgical-cut-down-for-vascular-access-with-conscious-sedation-for-transcatheter-aortic-valve-replacement-the-best-of-both-worlds
#5
Arturo Cardounel, Thomas G Gleason, Joon S Lee, John T Schindler, Dustin Kliner, Forozan Navid, Valentino Bianco, Ibrahim Sultan
OBJECTIVES: Despite the established efficacy of transcatheter aortic valve replacement for aortic valve replacement, vascular complications remain a major cause of procedural morbidity and mortality. In this study, we evaluate the use of femoral artery cut down with conscious sedation and report outcomes and complications associated with this approach. METHODS: Our study included 282 patients undergoing transcatheter aortic valve replacement with conscious sedation and surgical cut down for femoral access between 2015 and 2017...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29615354/improved-access-to-health-care-in-massachusetts-after-2006-massachusetts-healthcare-reform-law-is-associated-with-a-significant-decrease-in-mortality-among-vascular-surgery-patients
#6
Mohammad H Eslami, Katherine Moll Reitz, Denis V Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: Access to medical care, by adequate insurance coverage, has a direct impact on outcomes for patients undergoing vascular procedures. We evaluated in-hospital mortality for patients undergoing index vascular procedures before and after the Massachusetts Healthcare Reform Law (MHRL) in 2006, which mandated insurance for all Massachusetts residents, both in Massachusetts and throughout the United States. METHODS: The National Inpatient Sample was queried to identify patients undergoing interventions for peripheral arterial disease, carotid artery stenosis, and abdominal aortic aneurysms based on International Classification of Diseases, Ninth Revision, Clinical Modification procedural and diagnostic codes...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29575678/impact-of-percutaneous-femoral-arteriotomy-closure-using-the-manta-tm-device-on-vascular-and-bleeding-complications-after-transcatheter-aortic-valve-replacement
#7
Rodney De Palma, Magnus Settergren, Andreas Rück, Rikard Linder, Nawzad Saleh
OBJECTIVES: To evaluate the feasibility of fully percutaneous closure using a novel collagen-based vascular closure device after transfemoral aortic valve replacement (TAVR). BACKGROUND: TAVR is utilized increasingly for the treatment of severe symptomatic aortic stenosis. Vascular complications related to access and closure dominate the adverse event profile of the procedure despite progressively reducing arteriotomy caliber. The advent of a novel collagen-based device (MANTATM ) and preliminary data suggest this could be used as a routine percutaneous closure device...
March 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29571619/predictive-factors-of-recurrent-endovascular-intervention-for-cephalic-arch-stenosis-after-percutaneous-transluminal-angioplasty
#8
Marta Neves, Cristina Outerelo, Marta Pereira, Fernando Neves, Telmo Carvalho, Pedro Maia, Pedro Ponce
OBJECTIVE: Cephalic arch stenosis (CAS) is an important and recurring problem arising in hemodialysis patients because of the requirement for repeated interventions to maintain patency. The aim of this study was to determine predictive factors for recurrence of CAS after successful angioplasty. METHODS: A retrospective, case-control study was conducted at two ambulatory vascular access (VA) centers. All patients with a dysfunctional VA referred for an angiographic procedure and with a documented CAS as evidenced during the endovascular intervention (EI) between January 1, 2013, and December 31, 2015, were enrolled; 15 patients in whom an efficacious intervention was not possible were excluded...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29552935/structured-physical-assessment-of-arteriovenous-fistulae-in-haemodialysis-access-surveillance-a-missed-opportunity
#9
Victoria E Jackson, Helen Hurst, Sandip Mitra
INTRODUCTION: Arteriovenous fistulae remain the gold standard of vascular access in haemodialysis. There is currently no consensus on standardised methods of monitoring arteriovenous fistulae. Assessment techniques and practice remain widely variable. The purpose of this study is to determine whether existing evidence supports physical assessment as an effective tool and a good predictor of arteriovenous fistulae dysfunction to allow for timely intervention and improve outcomes. METHODS: A literature search was performed using CINAHL, PubMed, Medline and BNI databases and relevant search terms...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29552930/cardiac-implantable-electronic-device-and-vascular-access-strategies-to-overcome-problems
#10
Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29544403/dialysis-arteriovenous-access-monitoring-and-surveillance-according-to-the-2017-spanish-guidelines
#11
Ramon Roca-Tey, José Ibeas, Teresa Moreno, Enrique Gruss, José Luis Merino, Joaquín Vallespín, David Hernán, Patricia Arribas
The Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology (S.E.N.), vascular surgery (SEACV), interventional radiology (SERAM-SERVEI), infectious diseases (SEIMC), and nephrology nursing (SEDEN)), along with the methodological support of the Iberoamerican Cochrane Centre, has developed the Spanish Clinical Guidelines on Vascular Access for Hemodialysis. This article summarizes the main issues from the guideline's chapter entitled "Monitoring and surveillance of arteriovenous access...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29544387/a-case-series-of-favorable-vessel-dilatation-using-a-nitinol-scoring-element-equipped-helical-balloon-catheter-angiosculpt%C3%A2
#12
Ryo Sato, Tetsuhiko Sato, Yuichi Shirasawa, Chika Kondo, Masao Tadakoshi, Michio Fukuda, Nobuyuki Ohte, Kunio Morozumi
OBJECTIVE: Although percutaneous transluminal angioplasty is an effective therapy against vascular access failure in hemodialysis patients, recurrent stenosis imposes enormous burden for hemodialysis patients. A nitinol scoring element-equipped helical balloon catheter (AngioSculpt® ) has been altered the landscape for treating several vascular diseases. It is not, however, fully elucidated whether AngioSculpt for advanced vascular access stenosis, difficult to expand by conventional balloons, successfully provides bailout angioplasty...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29529961/role-of-stents-in-hemodialysis-vascular-access
#13
Kenneth Abreo, Adrian Sequeira
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29522810/vascular-complications-in-the-sapien-3-era-continued-role-of-transapical-approach-to-tavr
#14
W Toppen, W Suh, O Aksoy, P Benharash, C Bowles, R J Shemin, M Kwon
OBJECTIVE: With the introduction of the latest generation Sapien 3 transcatheter aortic valve, there has been a reduction in the usage of transapical (TA) approach for TAVRs in many centers. However, despite the smaller sheath size and more stream-lined delivery system, vascular complications continue to occur, especially in patients with peripheral vascular disease. Thus, our institution has maintained a stringent TA protocol aiming to prevent these complications. We hypothesize that this protocol has helped to reduce vascular complications and improve outcomes at our institution even in the Sapien 3 era...
March 6, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29512407/the-association-of-genotype-polymorphisms-with-vascular-access-patency-in-hemodialysis-patients
#15
Chun-Fan Chen, Chih-Ching Lin
Some hemodialysis patients suffer from repeat dysfunction of dialysis vascular access and need procedures of angioplasty, thrombectomy, and even temporary catheter use. Why these patients are vulnerable to vascular access dysfunction and how to improve its patency are imperative to be discovered. Traditional risk factors for vascular access function had been widely investigated but could not fully explain this question. Several genotype polymorphisms were demonstrated to increase the incidence of cardiovascular disease and might also be linked to higher risk of vascular access dysfunction...
February 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29462049/suprasternal-transcatheter-aortic-valve-replacement-in-patients-with-marginal-femoral-access
#16
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, David M Holzhey, Philipp Kiefer, L Wiley Nifong, Michael A Borger
OBJECTIVE: Recently, the PARTNER 2A trial reported results of transcatheter aortic valve replacement versus surgical aortic valve replacement in 2032 intermediate-risk patients at 2 years. Two hundred thirty-six patients (24%) required an access route other than transfemoral. Compared with transfemoral and surgical aortic valve replacement, nontransfemoral transcatheter aortic valve replacement was associated with a numerically higher rate of death and disabling stroke at 30 days. This underscores the need for a better alternative surgical approach for patients with marginal femoral access...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29455011/hybrid-retrograde-celiac-artery-stenting-for-acute-mesenteric-ischemia-after-gastric-surgery
#17
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29425561/impact-of-peripheral-artery-disease-on-early-and-late-outcomes-of-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-valve-stenosis
#18
Byung Gyu Kim, Young-Guk Ko, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong, Seung Hyun Lee, Sak Lee, Byung-Chul Chang
AIMS: Peripheral artery disease (PAD) is frequently present in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis. This study assessed the impact of PAD on clinical outcome after TAVI. METHODS: A total of 115 patients who underwent TAVI were evaluated retrospectively. Patients were divided into PAD and non-PAD groups, with PAD defined as stenosis≥50% in lower extremity arteries. Immediate and late clinical outcomes were compared between the two groups...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29421416/primary-stenting-of-right-sided-subclavian-artery-stenosis-presenting-as-subclavian-steal-syndrome-report-of-three-cases-and-literature-review
#19
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Pirgakis, Anastasios Lekkas, Ioannis Kantounakis, Alexandra Terzoglou, Vasileios Tzilalis
BACKGROUND: Right-sided subclavian artery stenosis is a rare cerebrovascular disease involving the upper extremities. Considering an endovascular approach for its management requires increased endovascular and catheterization skills, when compared to the left side, due to the close approximation of the right subclavian artery origin, vertebral and common carotid arteries. METHODS: Three patients suffering from proximal right sided subclavian artery stenosis were treated in our center through primary stenting...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29368369/recent-developments-and-controversies-in-transcatheter-aortic-valve-implantation
#20
REVIEW
Noman Ali, Peysh A Patel, Steven J Lindsay
Interventional cardiology has been revolutionised by transcatheter aortic valve implantation (TAVI), which has become established as the benchmark treatment for severe aortic stenosis in patients at high risk for surgical aortic valve replacement (AVR). Increased procedural familiarity and progression in device technology has enabled improvements to be made in complication rates, which have led to a commensurate expansion in the use of TAVI; it is now a viable alternative to AVR in patients at intermediate surgical risk, and has been used in cohorts such as those with bicuspid aortic valves or pure, severe aortic regurgitation...
January 25, 2018: European Journal of Heart Failure
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