Vascular imaging for hemodialysis vascular access planning

Abstract Introduction Central venous catheters (CVC) increase risks associated with hemodialysis (HD), but may be necessary until an arteriovenous fistula (AVF) or graft (AVG) is achieved. The impact of vascular imaging on achievement of working AVF and AVG has not been firmly established. Methods Retrospective cohort of patients initiating HD with CVC in 2010–2011, classified by exposure to venography or Doppler vein mapping, and followed through December 31, 2012. Standard and time‐dependent Cox models were used to determine hazard ratios (HRs) of death, working AVF, and any AVF or AVG. Logistic regression was used to assess the association of preoperative imaging with successful AVF or AVG among 18,883 individuals who had surgery. Models were adjusted for clinical and demographic factors. Findings Among 33,918 patients followed for a median of 404 days, 39.1% had imaging and 55.7% had surgery. Working AVF or AVG were achieved in 40.6%; 46.2% died. Compared to nonimaged patients, imaged patients were more likely to achieve working AVF (HR = 1.45 [95% confidence interval [CI] 1.36, 1.55], P  0.001), and less likely to die (HR = 0.88 [0.83‐0.94], P 
Source: Hemodialysis International - Category: Hematology Authors: Tags: Original Article Source Type: research

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ConclusionsTreatment of central vein obstructions in hemodialysis patients with stent grafts has been appealing owing to the tapered shape with a larger diameter and the availability of various lengths.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionsCandida fungemia is associated with a high mortality. CIED removal should be an early consideration in these patients even if lead vegetations are not seen.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
Majernikova Effective vascular access (VA) is an essential condition for providing hemodialysis, affecting patients’ health outcomes. We aim to explore how health literacy (HL) as a non-clinical factor is associated with the decision-making process regarding VA type selection. Using data from 20 dialysis centers across Slovakia (n = 542, mean age = 63.6, males = 60.7%), the association of HL with type of VA (arteriovenous fistula (AVF) vs. central venous catheter (CVC)) was analyzed using a logistic regression model adjusted for sociodemographic characteristics and comorbidity. Sociodemographic data and da...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
ConclusionsThe fibrous sheath of tunnelled CVCs is a reliable access for CVC re ‐insertion. This helps to preserve the same venous access site for repeated revision of CVCs. This is extremely important in those children who depend on long‐term CVC usage.
Source: Surgical Practice - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi, Bibek Sarki, Sana Khan, Kramer WahlbergIndian Journal of Nephrology 2020 30(1):29-31 Internal jugular vein (IJV) cannulation was originally described by English et al. in 1969 as the safest approach. Carotid artery puncture had an incidence rate of 4–6% before ultrasound guidance. We encountered an unexpected sequence of events following the ultrasound-guided placement of a temporary HD catheter in the left IJV. The postprocedure chest radiograph was misinterpreted as an arterial misplacement, the blood return was correspondingly bright red, and simultaneous ...
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
ConclusionsThe present meta-analysis revealed that, compared to PTS, PTA may provide increased assisted primary patency for endovascular treatment of central vein stenosis or occlusion in patients undergoing hemodialysis.Level of EvidenceLevel 3a.
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
CONCLUSION: Our results presented that regardless of the type of initial vascular access, limiting the length of the time using CVC as well as switching to AVF could significantly improve the survival of HD patients. PMID: 31880586 [PubMed - in process]
Source: Iranian Journal of Kidney Diseases - Category: Urology & Nephrology Tags: Iran J Kidney Dis Source Type: research
Authors: Kim DH, Park JI, Lee JP, Kim YL, Kang SW, Yang CW, Kim NH, Kim YS, Lim CS Abstract Background: Although arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD), the association between vascular access types and quality of life is not well-known. We investigated the relationships between HD vascular access types and all-cause mortality, health-related quality of life (HRQOL) and the degree of depression in a large prospective cohort.Methods: A total of 1461 patients who newly initiated HD were included. The initial vascular access types were classified into AVF, arteriovenous graf...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
This study aimed to review the outcomes of percutaneous treatment with a mother-child technique in the treatment of symptomatic central venous stenosis (CVS) and central venous occlusion (CVO) in patients on hemodialysis.MethodsData were collected retrospectively and included all consecutive patients with CVS or CVO who were treated with percutaneous angioplasty and stenting. The occlusive lesions were crossed using the mother-child technique with an angiographic catheter-in-guiding catheter system.ResultsA total of 36 patients with symptomatic CVS and 45 patients with total CVO were included. The average age and gender co...
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionsThe fibrous sheath of tunneled CVCs is a reliable access for CVC re ‐insertion. This helps to preserve the same venous access site for repeated revision of CVCs. This is extremely important in those children who depend on long‐term CVC usage.This article is protected by copyright. All rights reserved.
Source: Surgical Practice - Category: Surgery Authors: Tags: Original Article Source Type: research
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