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Vascular Access

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62 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29736915/planning-and-evaluation-for-vascular-access-in-the-elderly
#1
Candice Halinski, Holly M Koncicki
Vascular access is of vital importance for patients requiring dialysis therapies. AV fistulas have been endorsed by many professional societies as the access of choice, however, subsequent creation does not go without consequences. As the population ages and patients become more medically complex, access failure has become a major cause of treatment complication. For the elderly, this is especially true and there are multiple decision points that require careful reflection before an AVF is placed. This article reviews access considerations for AVF placement in the elderly population and considers the possibility that the fistula first approach to vascular access should not be an absolute...
May 8, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29730781/role-of-antiplatelet-therapy-in-the-durability-of-hemodialysis-access
#2
Satinderjit Locham, Robert J Beaulieu, Hanaa Dakour-Aridi, Besma Nejim, Mahmoud B Malas
BACKGROUND: Antiplatelet therapy (APT) is often used on anecdotal grounds to improve vascular access patency. The aim of this study was to assess the role of APT in hemodialysis (HD) patients undergoing arteriovenous fistula (AVF) or graft (AVG) placement. METHODS: All patients in a large HD vascular qualitative initiative database (2011-2017) were included and divided into no antiplatelet therapy (no-APT) vs. any APT [aspirin (ASA) or P2Y12 inhibitors (PI)]. Multivariate [logistic (MLR) and Cox (MCR) regression] analyses were used as appropriate...
May 5, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29685213/erythema-and-swelling-around-arteriovenous-fistula-sites-in-a-hemodialysis-patient
#3
Yusuke Kaida, Aki Minami, Misako Matsue-Fukuyama, Takeki Adachi, Hiroshi Nagata, Norito Ishii, Takekuni Nakama, Kei Fukami
No abstract text is available yet for this article.
May 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29667048/ethanol-lock-is-effective-on-reducing-the-incidence-of-tunneled-catheter-related-bloodstream-infections-in-hemodialysis-patients-a-systematic-review-and-meta-analysis
#4
REVIEW
Tingting Zhao, Hong Liu, Jibin Han
PURPOSE: The purpose of this meta-analysis is to evaluate the effect of ethanol lock on the incidence of catheter-related bloodstream infection (CRBSI) in patients with central venous catheters. METHODS: RCTs comparing ethanol lock with another solution lock for prevention of CRBSI were obtained by searching databases of PubMed, Embase, Web of Science and Cochrane Central Register of clinical trials for eligible randomized controlled trials (inception to December 2017)...
April 17, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29627998/physical-examination-of-the-hemodialysis-arteriovenous-fistula-to-detect-early-dysfunction
#5
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/29615350/a-technique-for-the-salvage-of-megafistulas-allowing-immediate-dialysis-access
#6
Nosratollah Nezakatgoo, Steven D Kozusko, Jefferson T Watson, Rebecca Empting, Charles P Shahan, Michael J Rohrer
OBJECTIVE: Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS: The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29529961/role-of-stents-in-hemodialysis-vascular-access
#7
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/29529962/angioplasty-to-promote-arteriovenous-fistula-maturation-and-maintenance
#8
Kenneth Abreo, Mary Buffington, Bharat Sachdeva
The arteriovenous fistula is currently the best permanent access for the hemodialysis patient. Unfortunately, stenosis impairs maturation, long-term survival, and function of the arteriovenous fistula. Angioplasty currently is the best procedure for the treatment of immature and dysfunctional arteriovenous fistulas. In this review, the authors discuss the optimum time to evaluate arteriovenous fistulas for maturity, methods of evaluation for maturity, and the role of angioplasty in salvaging immature arteriovenous fistulas...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29520968/post-operative-arterio-venous-fistula-blood-flow-influences-primary-and-secondary-patency-following-access-surgery
#9
Kapila S Benaragama, Jennifer Barwell, Chris Lord, Biku J John, Adarsh Babber, Shella Sandoval, Ben Lindsey, Bimbi Fernando
PURPOSE: Primary arteriovenous fistula arterio venous fistula (AVF) formation has proven to be the best and optimal vascular access for the majority of haemodialysis patients. At present there are limited data to suggest which haemodynamic parameters most correlate with the likelihood of early failure. The aim of this study is to identify the haemodynamic predictors of early failure, hence identify which fistulae may benefit from timely pre-emptive intervention. MATERIAL AND METHODS: Retrospective analysis of data was performed of 201 patients undergoing native AVF creation over a one year period...
March 9, 2018: Journal of Renal Care
https://www.readbyqxmd.com/read/29513901/do-arteriovenous-fistulas-increase-cardiac-risk
#10
Randall Faull, Nitesh Rao, Matthew Worthley
An effectively functioning arteriovenous fistula is the life line for patients on long-term hemodialysis, and for most an upper limb, native vessel fistula has significant short- and long-term advantages. There are, however, situations where a fistula has deleterious effects, including the relatively uncommon problem of severe heart failure exacerbated in particular by high-flow fistulas. There is also increasing evidence that a fistula can add to the already high burden of cardiovascular risk in patients with advanced kidney disease, including by promoting water and salt retention, and by inducing or worsening left ventricular hypertrophy...
March 7, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29517177/basilic-vein-transposition-for-unsuitable-upper-arm-hemodialysis-needle-access-segment-may-attenuate-concurrent-hand-ischemia
#11
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
https://www.readbyqxmd.com/read/29487092/clinical-trial-end-points-for-hemodialysis-vascular-access-background-rationale-and-definitions
#12
Surendra Shenoy, Michael Allon, Gerald Beathard, Deborah Brouwer-Maier, Laura M Dember, Mark Glickman, Celeste Lee, Terry Litchfield, Charmaine Lok, Thomas Huber, Prabir Roy-Chaudhury, Jack Work, Melissa West, Haimanot Wasse
No abstract text is available yet for this article.
March 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29477675/factors-associated-with-early-thrombosis-after-arteriovenous-fistula-creation
#13
Abraham Korn, Hamid Alipour, Joshua Zane, Ali Shahverdiani, Timothy J Ryan, Amy Kaji, Nina Bowens, Christian de Virgilio
BACKGROUND: Arteriovenous fistulas (AVF) are the preferred modality for hemodialysis access. Early thrombosis hampers development of a working AVF. We endeavored to determine the incidence 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 was created between November 2014 and July 2016 at a single center. Early thrombosis was defined as thrombosis that occurred within 30 days of surgery...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477678/prognostic-factors-for-arteriovenous-fistula-maturation
#14
Carney Chan, Christian J Ochoa, Steven G Katz
BACKGROUND: Recent studies have reported successful arteriovenous (AV) fistula maturation rates between 40% and 80%, with older age, distal fistula location, and small vein diameter associated with greater failure rates. Our objective is to determine if these findings are consistent with the outcomes at our institution. METHODS: A retrospective chart review was performed on patients who underwent upper extremity AV fistula creation at a single institution. Patient demographics and risk factors were analyzed, as well as fistula location and vein diameter based on preoperative ultrasound...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29478866/report-of-the-standardized-outcomes-in-nephrology-hemodialysis-song-hd-consensus-workshop-on-establishing-a-core-outcome-measure-for-hemodialysis-vascular-access
#15
Andrea K Viecelli, Allison Tong, Emma O'Lone, Angela Ju, Camilla S Hanson, Benedicte Sautenet, Jonathan C Craig, Braden Manns, Martin Howell, Eric Chemla, Lai-Seong Hooi, David W Johnson, Timmy Lee, Charmaine E Lok, Kevan R Polkinghorne, Robert R Quinn, Tushar Vachharajani, Raymond Vanholder, Li Zuo, Carmel M Hawley
Vascular access outcomes in hemodialysis are critically important for patients and clinicians, but frequently are neither patient relevant nor measured consistently in randomized trials. A Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop was convened to discuss the development of a core outcome measure for vascular access. 13 patients/caregivers and 46 professionals (clinicians, policy makers, industry representatives, and researchers) attended. Participants advocated for vascular access function to be a core outcome based on the broad applicability of function regardless of access type, involvement of a multidisciplinary team in achieving a functioning access, and the impact of access function on quality of life, survival, and other access-related outcomes...
May 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29481943/technique-to-avoid-hemodialysis-catheter-in-patients-with-failing-aneurysmal-arteriovenous-fistula-by-creating-a-concomitant-new-arteriovenous-fistula
#16
Kelly A Lara, Rochelle Anne Chua, Trung D Vo
Autogenous arteriovenous fistula (AVF) is the primary recommended access for hemodialysis. Long-term use will not uncommonly result in AVF aneurysmal degeneration. Aneurysm-associated complications encompass pain, skin ulceration, infection, thrombosis, cannulation difficulties, and life-threatening bleeding. Various methods to repair aneurysmal AVFs have been described. However, there may be circumstances when this is not possible and require insertion of a temporary hemodialysis catheter (HDC) until a new arteriovenous access is created...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29477238/vascular-access-of-last-resort
#17
REVIEW
Tushar J Vachharajani, Anil K Agarwal, Arif Asif
Exhausted vasculature is not uncommon in patients receiving long-term hemodialysis treatment. Certain patients exhaust their peripheral veins and do not retain the venous capital necessary for fistula creation. Others suffer from severe peripheral arterial disease and despite the presence of adequate venous capital are not able to receive an arteriovenous access successfully. Most importantly, in the case of occluded central veins, the creation of an arteriovenous access in the arms or thighs would be futile, even if peripheral veins and/or arteries were available...
April 2018: Kidney International
https://www.readbyqxmd.com/read/29471988/multicenter-randomized-trial-of-conventional-balloon-angioplasty-versus-paclitaxel-coated-balloon-angioplasty-for-the-treatment-of-dysfunctioning-autologous-dialysis-fistulae
#18
Geert Maleux, Ward Vander Mijnsbrugge, Denis Henroteaux, Annouschka Laenen, Sandra Cornelissen, Kathleen Claes, Inge Fourneau, Nicolas Verbeeck
PURPOSE: To investigate the potential added value of paclitaxel-coated balloon (PCB) angioplasty to reduce fistula dysfunction related to recurrent stenoses in patients undergoing hemodialysis. MATERIALS AND METHODS: A prospective, randomized study was conducted in 3 dialysis referral centers. From January 2013 to October 2015, 64 patients (22 female, 42 male) with dysfunctional autologous dialysis fistulae were randomized to undergo conventional percutaneous balloon angioplasty (n = 31) or PCB angioplasty (n = 33)...
April 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29452835/a-comparison-of-preoperative-and-intraoperative-vein-mapping-sizes-for-arteriovenous-fistula-creation
#19
Samuel H Hui, Ryan Folsom, Lois A Killewich, Joel E Michalek, Mark G Davies, Lori L Pounds
BACKGROUND: Duplex ultrasound (DUS) mapping of the veins and arteries of the upper extremity is a well-established practice in arteriovenous fistula creation for long-term hemodialysis access. Previous publications have shown that vein diameters varying from 2 to 3 mm are predictive of success. Regional anesthesia is known to result in vasodilation and thus to increase the diameter of upper extremity veins. This study compares the sizes of veins measured by preoperative DUS mapping with those obtained after regional anesthesia to determine whether intraoperative DUS results in increased vein diameters and thus changes in the operative plan...
February 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29399534/hemodialysis-access-thrombosis
#20
REVIEW
Keith Bertram Quencer, Rahmi Oklu
For the over 400,000 patients in the United States dependent on hemodialysis, arteriovenous (AV) access thrombosis may lead to missed dialysis sessions, inpatient admissions and the need for placement of temporary dialysis catheters. It is also the leading cause of permanent access loss. Percutaneous declotting is generally preferred over surgical thrombectomy. Various percutaneous approaches can be employed including the lyse-and-wait technique, thromboaspiration, pulse spray aided pharmacomechanical thrombolysis, and use of mechanical thrombectomy device...
December 2017: Cardiovascular Diagnosis and Therapy
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