Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft?

Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft? J Vasc Access. 2019 Apr 12;:1129729819841153 Authors: Inston N, Khawaja A, Mistry H, Jones R, Valenti D Abstract BACKGROUND: Running out of vascular access for dialysis is thankfully rare, but despite this, most units will have a number of patients with few options and in a precarious state. The increasing longevity of dialysis patients portends more patients will reach minimal access options. End stage vascular access is poorly defined but classification may enable assessment and comparison of treatment options. Three options for patients with end stage access are a central venous catheter through a translumbar or transhepatic route, arterial-arterial prosthetic loop or a right atrial graft. AIMS: The aims of this study are to provide a structured review of evidence for these procedures to allow application and guide practice for patients with end stage vascular access. METHODS: A standardised search of published literature was performed of relevant studies. In addition, the references cited in those papers were assessed for any further available articles. All study types were included and reviewed by two authors independently. Primary outcomes were patient survival and secondary patency rate at 3 and 12 months. Secondary outcomes were long-term patency rates, mean time to cannulation and complications such as access dysfunction, th...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research

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We report our experience with early-cannulation Hemodialysis Reliable Outflow grafts and compare them to traditional Hemodialysis Reliable Outflow grafts. METHODS: We retrospectively reviewed all patients undergoing Hemodialysis Reliable Outflow graft placement from 1 January 2013 through 15 August 2017 at our institution and compared those undergoing placement of traditional Hemodialysis Reliable Outflow grafts and simultaneous tunneled dialysis catheter insertion to those undergoing Hemodialysis Reliable Outflow graft placement using an early-cannulation Hemodialysis Reliable Outflow graft without a tunneled dialysis...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Authors: DeGiovanni J, Son A, Salehi P Abstract We are reporting a case of venous thoracic outlet syndrome with recurrent subclavian vein thrombosis in the setting of an ipsilateral brachiocephalic arteriovenous fistula for hemodialysis that was malfunctioning due to the central vein obstruction. The patient also had a concomitant external jugular vein origin stenosis. Given her body habitus and aversion to recovery after traditional first rib resection, we elected for an alternative treatment with an external jugular vein to internal jugular vein transposition with balloon angioplasty of the stenosed external jugu...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
ConclusionsIn our experience, venous bypass combined with thoracic outlet decompression achieves symptomatic relief in approximately 90% of patients with symptomatic upper extremity central venous occlusion, with morbidity limited to the perioperative period.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Rationale: As survival prospects improve for long-term patients with hemodialysis, it is common for patients to exhaust all upper extremity access options before other avenues need exploration. The purpose of this case report was to describe our experience in creating a prosthetic graft between left femoral artery and right femoral vein in a patient with history of central venous occlusion and bilateral femoral neck fracture. Patient concerns: A female patient with hemodialysis exhausted all upper extremity access options along with bilateral femoral neck fracture. Diagnoses: Patients with end-stage renal disease e...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Condition:   Central Venous Catheter Thrombosis Interventions:   Procedure: inside-out-access technique with inside-out access device (Surfacer (R));   Procedure: access technique including Sharp recanalization Sponsor:   Medical University of Vienna Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Access Vascular, based in Massachusetts, has developed a peripherally inserted central venous catheter (PICC) composed of a thromboresistant hydrogel material. The catheter could reduce the incidence of catheter-related thrombi and resulting adverse ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Emergency Medicine Exclusive Materials Radiology Surgery Vascular Surgery Source Type: blogs
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