Usefulness of assisted procedures for arteriovenous fistula maturation without compromising access patency
Abstract Introduction To increase the rate of arteriovenous fistula (AVF) use, assisted procedures for immature AVF have been strenuously performed. However, this is controversial in that an AVF matured by these assisted procedures may require more frequent intervention to maintain its patency, and have decreased long‐term patency. Methods Eighty four AVFs that were matured with assisted maturation procedures and 266 AVFs that matured spontaneously without intervention, created between November 2009 and March 2013 from the hemodialysis (HD) vascular access (VA) cohort, were compared retrospectively and we also investigated the factors that may influence AVF long‐term patency. Median follow‐up was 26.8 months (interquartile range, 6.6–45.0 months). Findings Access survival did not differ between AVFs matured by assisted procedures and spontaneously mature AVFs (P = 0.29). In multivariate Cox regression analysis of AVF survival, age (HR, 1.029; 95% CI, 1.004–1.056; P = 0.024), maturation without assisted procedures 4–6 weeks after AVF creation (HR, 0.233; 95% CI, 0.107–0.506; P
To evaluate the use of Intravascular ultrasound to identify the incidence of thrombus associated with tunneled hemodialysis catheters, during exchange of said malfunctioning catheters.
This study investigated the effects of Resolvin D1 therapy on AVF healing and maturation in mice with chronic kidney disease (CKD).
Venous thrombosis in a pediatric population can be multifactorial such as secondary to extrinsic compression syndromes: Paget-Schroetter syndrome, May-Thurner syndrome (iliac vein thrombosis), hypercoagulable state, PICC or other central venous catheters and can also occur in patients with arteriovenous fistulae or grafts in patients requiring long-term hemodialysis. DVT affects 0.07-0.14 in 10,000 children annually;58 per 10,000 in hospitalized children. Catheter-directed thrombolysis (CDT), venous angioplasty, stent placement, and mechanical thrombectomy are used to treat both acute and chronic venous thrombosis.
Acute kidney injury (AKI) is a serious and frequent complication in the intensive care unit (ICU)  and can require the initiation of renal replacement therapy (RRT). Venous catheters are currently the preferred vascular access route for patients with AKI who require RRT [2,3], but there is a risk of catheter infection or thrombosis. To prevent these complications, lock solutions are instilled into the lumen of the hemodialysis catheter after each session and left in place until the next use. Sodium citrate and heparin locks are widely used.
CONCLUSION: The technique described allows elevation of the vein to the level of the dermis without division and re-anastomosis or re-tunneling, through several small incisions maintaining virgin skin and normal contour for easier cannulation. PMID: 31992105 [PubMed - as supplied by publisher]
Publication date: Available online 25 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Zhi-Huang Qiu, Liang-Wan Chen, Lian-Ming Liao, Jun Xiao, Xiao-Fu Dai, Guan-Hua Fang, Liang-Liang Yan, Qing-Song Wu, Quan-Fang LuoAbstractBackgroundThe efficacy of hemiarch replacement combined with a modified triple-branched stent graft in Debakey type I aortic dissection remains to be confirmed.MethodsFrom January 2016 to December 2017, 167 patients with acute Debakey type I aortic dissection underwent hemiarch replacement combined with a modified triple-branched stent graft. The clinical and imaging data were retrospectivel...
Abstract BACKGROUND: The efficacy of hemiarch replacement combined with a modified triple-branched stent graft in Debakey type I aortic dissection remains to be confirmed. METHODS: From January 2016 to December 2017, 167 patients with acute Debakey type I aortic dissection underwent hemiarch replacement combined with a modified triple-branched stent graft. The clinical and imaging data were retrospectively analyzed. The early composite endpoint was defined to comprise perioperative mortality, permanent neurological deficits, and renal failure requiring hemodialysis at discharge. RESULTS: The overall 30-d...
CONCLUSIONS: This study for the first time demonstrates that TMAO promotes vascular calcification through activation of NLRP3 inflammasome and NF-κB signals, suggesting the potential link between gut microbial metabolism and vascular calcification. Reducing the levels of TMAO could become a potential treatment strategy for vascular calcification in chronic kidney disease. PMID: 31941382 [PubMed - as supplied by publisher]
ConclusionThe atypical hemolytic uremic syndrome is a rare disease entity requiring a high index of suspicion to diagnose. It is a diagnosis of exclusion. Early diagnosis with prompt treatment will render a better outcome. The atypical hemolytic uremic syndrome needs to be considered in all patients with thrombotic microangiopathy.
Authors: Sarioglu O, Capar AE, Belet U Abstract BACKGROUND: The platelet-lymphocyte ratio, which was reported to have a strong relationship with chronic inflammation and thrombosis, is a useful biomarker. The purpose of this study was to evaluate the relationship between the platelet-lymphocyte ratio, arteriovenous stenosis, and thrombosis in patients with chronic renal failure. METHODS: Patients who were referred to our interventional radiology department due to arteriovenous fistula dysfunction from dialysis units between August 2015 and December 2018 were retrospectively reviewed. In the study, 95 patients w...