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dialysis arteriovenous fistula

Julien Al Shakarchi, C Day, N Inston
INTRODUCTION: Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. METHOD: A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. RESULTS: Our cohort consisted of 74 patients...
March 1, 2018: Journal of Vascular Access
Kanyu Miyamoto, Naoya Matsuoka, Sumihisa Ono, Shinya Nakamura, Kohei Nagaya, Nao Asai, Kazuhiro Nishikawa, Yasuhiko Ito, Hirokazu Imai
INTRODUCTION: We report a case in which we performed an anastomotic part septal formation surgery (anastoplasty) and artificial blood vessel replacement surgery. CASE DESCRIPTION: When forearm arteriovenous fistula occlusion of a dialysis patient was observed, there was a thrombus in the vein of the whole forearm from the anastomotic part. We performed a septum formation surgery to suppress the blood flow in the vein near the anastomotic site, and artificial blood vessel replacement was performed on the high stenosis of the cephalic vein of the elbow...
March 1, 2018: Journal of Vascular Access
Takao Okawa, Masaaki Murakami, Ryo Yamada, Satoshi Tanaka, Kiyoshi Mori, Noriko Mori
PURPOSE: The population of obese patients is increasing in general and also at hemodialysis initiation. For successful cannulation of arteriovenous fistula, the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines suggest that the required maturation parameters are at a depth of <6 mm. There are several reports describing two-stage superficialization of arteriovenous fistulas in obese cases. Therefore, we investigated the utility and complications of one-stage superficialization of radio-cephalic fistula...
March 1, 2018: Journal of Vascular Access
Panagiotis M Kitrou, Konstantinos Katsanos, Panagiotis Papadimatos, Stavros Spiliopoulos, Dimitris Karnabatidis
Thrombosis is the most important access-related complication. Several declotting procedures have been suggested falling mainly into two categories; thrombolysis-dependent and thrombectomy-dependent. Areas covered: Seventeen studies after 2001 have been published on percutaneous treatment of thrombosed vascular access. Authors performed a systematic review of these studies together with a parametric meta-analysis of data available investigating clinical success, postintervention assisted primary patency (PAPP) and independent factors that could influence outcome measures...
March 21, 2018: Expert Review of Medical Devices
Alexandros Mallios, William Jennings, Benoit Boura, Alessandro Costanzo, Myriam Combes
Skin necrosis overlying an arteriovenous fistula at the cannulation site is a common and potentially life-threatening problem, often associated with underlying aneurysm formation. Arteriovenous fistula-skin necrosis generally requires resection of surrounding skin margins and the underlying aneurysmal vessel wall, allowing repair with healthy tissue of the arteriovenous fistula in addition to closure of soft tissue and skin. In patients with insufficient fistula length, salvage of these arteriovenous fistulas may result in difficult or insurmountable cannulation issues leading to attempts at one-needle cannulation dialysis or, most often, catheter placement...
March 1, 2018: Journal of Vascular Access
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
John J Sim, Hui Zhou, Jiaxiao Shi, Sally F Shaw, Shayna L Henry, Csaba P Kovesdy, Kamyar Kalantar-Zadeh, Steven J Jacobsen
PURPOSE: The early period after chronic kidney disease (CKD) patients transition to end-stage renal disease (ESRD) represents the highest mortality risk but is variable among different patient populations and clinical circumstances. We compared early mortality outcomes among a diverse CKD population that transitioned to ESRD. METHODS: A retrospective cohort study (1/1/2002 through 12/31/2013) of CKD patients (age ≥ 18 years) who transitioned to peritoneal dialysis (PD), hemodialysis (HD) with arteriovenous fistula/grafts, and HD with catheters was performed...
March 12, 2018: International Urology and Nephrology
Mohammad A Hossain, Amy Quinlan, Jennifer Heck-Kanellidis, Dawn Calderon, Tejas Patel, Bhavika Gandhi, Shrinil Patel, Mahida Hetavi, Eric J Costanzo, James Cosentino, Chirag Patel, Asa Dewan, Yen-Hong Kuo, Loay Salman, Tushar J Vachharajani
BACKGROUND: While transradial approach to conduct percutaneous coronary interventions offers multiple advantages, the procedure can cause radial artery damage and occlusion. Because radial artery is the preferred site for the creation of an arteriovenous fistula to provide dialysis, patients with chronic kidney disease are particularly dependent on radial artery for their long-term survival. METHODS: In this retrospective study, we investigated the prevalence of chronic kidney disease in patients undergoing coronary interventions via radial artery...
March 1, 2018: Journal of Vascular Access
Yuki Horita
The objectives of central venous percutaneous transluminal angioplasty are to dilate the venous lesion and to extend the life of arteriovenous fistula for hemodialysis. It is reasonable to perform percutaneous transluminal angioplasty for central venous lesions if this interventional therapy is required to maintain stable dialysis therapy. However, the presence of large fresh thrombus at central venous lesion site represents a contraindication to percutaneous transluminal angioplasty unless the thrombus can first be removed by thrombectomy...
March 1, 2018: Journal of Vascular Access
Safauldeen A Alhajim
Chronic kidney disease requires life-long renal replacement therapy, which can greatly impair the quality of life (QOL) of patients. This cross-sectional study aimed to assess the QOL of patients on haemodialysis, and the factors affecting it, at the dialysis unit of Basra General Hospital. A total of 104 patients with end-stage renal disease on haemodialysis were included. Data were collected using the World Health Organization QOL questionnaire. Sociodemographic and clinical data were also collected. Of the 104 patients, 57% were male, 73% were older than 45 years, 87% were of middle and low socioeconomic status, 70% had been on dialysis for more than 1 year, 74% had arteriovenous fistula vascular access, 34% had diabetes and 48% were positive for hepatitis virus...
March 5, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Amir A Ghaffarian, Ragheed Al-Dulaimi, Larry W Kraiss, Mark Sarfati, Claire L Griffin, Brigitte K Smith, Graham Donald, Benjamin S Brooke
OBJECTIVE: Arteriovenous (AV) fistulas are the preferred hemodialysis access for patients with end-stage renal disease, although multiple interventions are typically needed to maintain patency. When AV fistulas thrombose, however, there is debate as to whether open thrombectomy should be attempted, particularly for salvage of upper arm fistulas. This study was designed to evaluate outcomes after open thrombectomy of upper arm and forearm AV fistulas compared with AV grafts. METHODS: We identified all patients who underwent an open thrombectomy procedure for a thrombosed AV fistula or graft at a single academic medical center between January 2006 and March 2017...
March 8, 2018: Journal of Vascular Surgery
Jesse D Schold, Stuart M Flechner, Emilio D Poggio, Joshua J Augustine, David A Goldfarb, John R Sedor, Laura D Buccini
BACKGROUND: The effects of underlying noncodified risks are unclear on the prognosis of patients with end-stage renal disease (ESRD). We aimed to evaluate the association of residential area life expectancy with outcomes and processes of care for patients with ESRD in the United States. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult patients with incident ESRD between 2006 and 2013 recorded in the US Renal Data System (n=606,046)...
March 7, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kamran Mohiuddin, David C Bosanquet, Nafi Dilaver, Anthony Davies, Christopher G Davies
BACKGROUND: Significant stenoses in arteriovenous fistulae or grafts (AVFs or AVGs) with limitation of flow and dialysis inadequacy should prompt consideration for fistuloplasty. We sought to identify fistulae, lesions and patient specific variables which predict for outcomes after fistuloplasty. METHOD: ology: Data were extracted retrospectively from renal access database from 2011 to 2016 of patients undergoing fistuloplasty. Demographics, co-morbidities, outcome of intervention and flow rate documented on pre and post intervention duplex were collected...
March 6, 2018: Annals of Vascular Surgery
Michael W M Gerrickens, Roel H D Vaes, Bastiaan Govaert, Joep A W Teijink, Marc R Scheltinga
INTRODUCTION: Some hemodialysis patients with a brachial arteriovenous fistula (AVF) have an unsuitable upper arm needle access segment (NAS) necessitating basilic vein transposition (BVT). It was frequently observed that a portion of these patients spontaneously experienced a warmer and less painful dialysis hand after BVT. Aim of this study was to determine whether BVT for an inadequate NAS attenuated hemodialysis access-induced distal ischemia in patients with a brachial AVF. METHODS: Patients with a brachial AVF and an unsuitable NAS also reporting hand ischemia and scheduled to undergo BVT between 2005 and 2016 in a single facility were studied...
March 8, 2018: Hemodialysis International
Gary Lambert, Jonathan Freedman, Susan Jaffe, Teun Wilmink
INTRODUCTION: To compare open surgical and radiological interventions for thrombosed arteriovenous access for dialysis. METHODS: A retrospective analysis of access procedures and dialysis episodes from 1 December 2002 to 30 November 2015 with follow-up up to 1 August 2016. Hospital records and dialysis database interrogated for further interventions and length of functional use. RESULTS: Some 128 surgical and 27 radiological thrombectomies were compared...
March 1, 2018: Journal of Vascular Access
Andreas Hjelm Brandt
This PhD project is based on a longstanding collaboration between physicists and engineers from the Center of Fast Ultrasound Imaging (CFU) at the Technical University of Denmark and medical doctors from the department of Radiology at Rigshospitalet. The intent of this cooperation is to validate new ultrasonic methods for future clinical use. 
Study I compares two B-mode ultrasound methods: the new experimental technique Synthetic Aperture Sequential Beam-forming combined with Tissue Harmonic Imaging (SASB-THI), and a conventional technique combined with THI...
March 2018: Danish Medical Journal
Sushil Mehandru, Attiya Haroon, Avais Masud, Mayurkumar Patel, Elmer Sadiang-Abay, Eric J Costanzo, Tushar J Vachharajani
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation...
March 1, 2018: Journal of Vascular Access
Federico Nalesso, Francesco Garzotto, Eva Muraro, Alessandra Brendolan, Claudio Ronco
Arteriovenous fistula cannulation for dialysis treatments in Europe has traditionally been done by metal needles. In -Japan, plastic cannulas have been available for many years and are used in the majority of the dialysis patients. The mechanical structure and the cannulation procedure of the plastic cannulas differ from those of the metal needles. These differences are particularly beneficial for patients with delicate fistulas, tortuous vessels, metal allergies, oligophrenic patients, and also for the safety of the medical staff...
January 26, 2018: Blood Purification
Kelsey Gray, Abraham Korn, Joshua Zane, Gabriel Conzalez, Amy Kaji, Nina Bowens, Christian de Virgilio
INTRODUCTION: Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended prior to hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. METHODS: This is a retrospective review of all patients that underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents...
February 22, 2018: Annals of Vascular Surgery
Abraham Korn, Hamid Alipour, Joshua Zane, Ali Shahverdiani, Timothy J Ryan, Amy Kaji, Nina Bowens, Christian de Virgilio
OBJECTIVE: Arteriovenous fistulas (AVF) are the preferred modality for hemodialysis access. Early thrombosis hampers development of a working AVF. We endeavored to determine the incidence of, and identify factors associated with early thrombosis of AVF, and to determine salvage rates following thrombosis, at a high volume hemodialysis access center. METHODS: Retrospective review of autologous AVF created between November 2014 and July 2016 at a single center. Early thrombosis was defined as thrombosis that occurred within 30 days of surgery...
February 22, 2018: Annals of Vascular Surgery
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