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Vascular Access

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7 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27866375/pre-operative-assessment-for-arteriovenous-fistula-placement-for-dialysis
#1
REVIEW
Maria G Marques, Pedro Ponce
Native AV fistulas are considered to be the best VA for most dialysis patients. A careful preoperative process of care is essential to maximize the proportion of fistulas that achieve adequacy for dialysis. An individualized and timely evaluation of patients starts early with the identification of risk factors, followed by a physical examination which should be complemented by ultrasound vascular mapping in most cases. Vascular mapping includes any technique that leads to information on patient's inflow and outflow anatomy (± hemodynamics) as they relate to arteriovenous access creation and may predict maturation...
November 20, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27630181/predictors-of-initiation-for-predialysis-arteriovenous-fistula
#2
Alian Al-Balas, Timmy Lee, Carlton J Young, Jill Barker-Finkel, Michael Allon
BACKGROUND AND OBJECTIVES: The optimal timing of predialysis arteriovenous fistula surgery remains uncertain. We evaluated factors associated with hemodialysis initiation in patients undergoing predialysis arteriovenous fistula surgery and derived a model to predict future initiation of dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our study retrospectively identified 308 patients undergoing predialysis arteriovenous fistula creation at a large medical center in 2006-2012 to determine whether they initiated hemodialysis...
September 14, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27605542/the-survival-benefit-of-fistula-first-catheter-last-in-hemodialysis-is-primarily-due-to-patient-factors
#3
Robert S Brown, Bhanu K Patibandla, Alexander S Goldfarb-Rumyantzev
Patients needing hemodialysis are advised to have arteriovenous fistulas rather than catheters because of significantly lower mortality rates. However, disparities in fistula placement raise the possibility that patient factors have a role in this apparent mortality benefit. We derived a cohort of 115,425 patients on incident hemodialysis ≥67 years old from the US Renal Data System with linked Medicare claims to identify the first predialysis vascular access placed. We compared mortality outcomes in patients initiating hemodialysis with a fistula placed first, a catheter after a fistula placed first failed, or a catheter placed first (n=90,517; reference group)...
September 7, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27492146/central-venous-occlusion-in-the-hemodialysis-patient
#4
Vinay Narasimha Krishna, Joseph B Eason, Michael Allon
Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27401525/new-insights-into-dialysis-vascular-access-impact-of-preexisting-arterial-and-venous-pathology-on-avf-and-avg-outcomes
#5
Roberto I Vazquez-Padron, Michael Allon
Despite significant improvements in preoperative patient evaluation and surgical planning, vascular access failure in patients on hemodialysis remains a frequent and often unforeseeable complication. Our inability to prevent this complication is, in part, because of an incomplete understanding of how preexisting venous and arterial conditions influence the function of newly created arteriovenous fistulas and grafts. This article reviews the relationship between three preexisting vascular pathologies associated with CKD (intimal hyperplasia, vascular calcification, and medial fibrosis) and hemodialysis access outcomes...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27401524/new-insights-into-dialysis-vascular-access-what-is-the-optimal-vascular-access-type-and-timing-of-access-creation-in-ckd-and-dialysis-patients
#6
Karen Woo, Charmaine E Lok
Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care...
August 8, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27203778/bioengineered-human-acellular-vessels-for-dialysis-access-in-patients-with-end-stage-renal-disease-two-phase-2-single-arm-trials
#7
MULTICENTER STUDY
Jeffrey H Lawson, Marc H Glickman, Marek Ilzecki, Tomasz Jakimowicz, Andrzej Jaroszynski, Eric K Peden, Alison J Pilgrim, Heather L Prichard, Malgorzata Guziewicz, Stanisław Przywara, Jacek Szmidt, Jakub Turek, Wojciech Witkiewicz, Norbert Zapotoczny, Tomasz Zubilewicz, Laura E Niklason
BACKGROUND: For patients with end-stage renal disease who are not candidates for fistula, dialysis access grafts are the best option for chronic haemodialysis. However, polytetrafluoroethylene arteriovenous grafts are prone to thrombosis, infection, and intimal hyperplasia at the venous anastomosis. We developed and tested a bioengineered human acellular vessel as a potential solution to these limitations in dialysis access. METHODS: We did two single-arm phase 2 trials at six centres in the USA and Poland...
May 14, 2016: Lancet
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