Early experience and observations in endovascular dialysis fistula re-intervention.
Authors: Jones RG, Khawaja A, Tullett K, Inston NG Abstract In recent years, new emerging technology has allowed the endovascular creation of dialysis fistulas in the proximal forearm without the need for open surgery. Two such systems currently exist, and evidence to date has demonstrated high rates of technical success in fistula creation, high rates of dialysis functionality, and low rates of re-intervention using both systems. Whilst early trial data has demonstrated lower rates of re-intervention to maintain patency compared to surgical fistulas, endovascular re-interventions are still required to maintain fun...
Source: The Journal of Vascular Access - December 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Influence of arm position change from adduction to abduction on intracavitary electrocardiogram.
CONCLUSION: Peripherally inserted central catheter moves toward the heart when the arm position changes from abduction to adduction. Peripherally inserted central catheter tip placement at the peak P wave with patient's arm in adduction is accurate and can prevent the catheter from advancing too low. R wave can function as a reference for observing P wave changes during peripherally inserted central catheter placement. PMID: 31808719 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - December 8, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Epicutaneo-caval catheters in neonates: New insights and new suggestions from the recent literature.
Authors: Barone G, Pittiruti M Abstract Epicutaneo-caval catheters have been widely used in neonatal intensive care units since Shaw has described them in 1973. These central venous access devices are usually placed at bedside and they have the purpose of delivering parenteral nutrition and/or drugs that are not compatible with the peripheral route. Even though in the last decade there was a fast advancement in the world of vascular access devices, such changes have only marginally affected the field of neonatal venous access. The aim of this editorial is to give 10 recommendations that correspond to 10 novelties i...
Source: The Journal of Vascular Access - December 7, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Ultrasound-guided removal of organized thrombi using biopsy forceps in dialysis patients with arterio-venous access occlusion.
CONCLUSION: This method was considered to be a valuable choice as a countermeasure against organized thrombi. PMID: 31782681 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - December 1, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Ultrasound-based simulation for cannulation in outpatient hemodialysis units: An educational protocol.
This article details an educational protocol including hands-on simulation for training dialysis technicians and nurses in ultrasound-guided cannulation techniques. PMID: 31782682 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - December 1, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Patient selection, education, and cannulation of percutaneous arteriovenous fistulae: An ASDIN White Paper.
Authors: Wasse H, Alvarez AC, Brouwer-Maier D, Hull JE, Balamuthusamy S, Litchfield TF, Cooper RI, Rajan DK, Niyyar VD, Agarwal AK, Abreo K, Lok CE, Jennings WC Abstract End-stage kidney disease patients who are candidates for surgical arteriovenous fistula creation commonly experience obstacles to a functional surgical arteriovenous fistula, including protracted wait time for creation, poor maturation, and surgical arteriovenous fistula dysfunction that can result in significant patient morbidity. The recent approval of two endovascular devices designed to create a percutaneous arteriovenous fistula enables arteri...
Source: The Journal of Vascular Access - December 1, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Cubital vein transposition for a distal radiocephalic fistula complicated by outflow obstruction.
CONCLUSION: Outflow reconstruction through the elbow bypass by cubital vein transposition is a valuable resource to rescue radiocephalic arteriovenous fistula complicated by outflow obstruction, avoiding the use of an interim central vein catheter. Endovascular treatment is vital to maintain functional patency in the mid- and long term. PMID: 31774035 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - November 28, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

A double-blind, randomized, placebo-controlled pilot trial to evaluate safety and efficacy of vorapaxar on arteriovenous fistula maturation.
CONCLUSION: Fewer than half of participants had functional maturation within 180 days after surgery, suggesting a major need for agents or strategies that enhance arteriovenous fistula maturation. PMID: 31774037 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - November 28, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

The impact of flushing with pre-filled saline syringes on the incidence of peripheral venous catheter failure: A quasi-experimental study.
Authors: Saliba P, Cuervo G, Hornero A, De Carli G, Marani A, Puro V, Felisa López A, Iftimie S, Castro A, Diaz-Brito Fernandez V, Alvarez Moya MC, Jimenez De La Rosa C, Martínez-Sánchez J, Jimenez E, Carratalà J, Pujol M Abstract BACKGROUND: Short peripheral venous catheters are one of the most frequently used devices in hospitals. Peripheral venous catheter failure, defined as the unscheduled dysfunction of peripheral venous catheter, is common and frequently entails a new invasive procedure. Flushing the catheter maintains patency and could prolong peripheral venous catheter dwell tim...
Source: The Journal of Vascular Access - November 27, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Giant brachial artery aneurysm as a rare complication of a dialysis shunt.
Authors: Schilling EM, Weinrich M, Heller T, Koball S, Neumann A Abstract Our patient exhibited a large tumor on his right upper arm where his former dialysis access site had been. X-ray, Doppler ultrasound, and magnetic resonance imaging scan could not fully reveal the nature of that tumor. Eventually, a surgical approach showed a giant aneurysm of the inflowing brachial artery to a partially obliterated arteriovenous fistula. This case highlights the importance of ongoing care for patients with arteriovenous shunts. Even arteriovenous fistulas, that are obliterated or no longer in use, can, especially when immuno...
Source: The Journal of Vascular Access - November 20, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial.
Authors: Dai C, Li J, Li QM, Guo X, Fan YY, Qin HY Abstract PURPOSE: To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound. METHODS: A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted cen...
Source: The Journal of Vascular Access - November 12, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Radial artery-first dorsal metacarpal vein arteriovenous fistula in the first interdigital space of the dorsal hand for hemodialysis.
Authors: Takashima T, Nakashima Y, Suenaga A, Yamashita Y, Nonaka Y, Fukuda M, Rikitake S, Miyazono M, Rikitake K, Ikeda Y Abstract A radiocephalic arteriovenous fistula in the anatomical snuffbox (tabatière region) was first described in 1969 as the most peripheral site for arteriovenous fistula in the upper limb. In cases in which the internal diameter of the first dorsal metacarpal vein under avascularization is ⩾2.0 mm, we have adopted a new operative technique for creating a radial artery-first dorsal metacarpal vein arteriovenous fistula in the first interdigital space of the dorsal hand, which lies ...
Source: The Journal of Vascular Access - November 8, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Pre- and post-review of a standardized ultrasound-guided central venous catheterization curriculum evaluating procedural skills acquisition and clinician confidence.
The objective of this quality improvement research was to evaluate both novice (50) clinicians' confidence across 100 ultrasound-guided central venous catheter insertion courses were performed at a mixture of teaching and non-teaching hospitals across 26 states within the United States between April 2015 and April 2016. A total of 1238 attendees completed a pre- and post-survey after attending a mixed method clinical simulation course. Attendees completed a 4-h online didactic education module followed by 4 h of hands-on clinical simulation stations (compliance/sterile technique, needling techniques, vascular ultras...
Source: The Journal of Vascular Access - November 8, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Saturday multidisciplinary hemodialysis access clinics to enhance patient care.
Authors: Levitsky LT, Ruske J, Hentschel DM, Nguyen LL, Ozaki CK, Shah SK Abstract Fragmentation of outpatient care is a substantial barrier to creation and maintenance of hemodialysis access. To improve patient accessibility, satisfaction, and multidisciplinary provider communication, we created a monthly Saturday multidisciplinary vascular surgery and interventional nephrology access clinic at a tertiary care hospital in a major urban area for the complicated hemodialysis patient population. The study included patients presenting for new access creation as well as those who had previously undergone access surgery...
Source: The Journal of Vascular Access - November 5, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

PICC-PORT totally implantable vascular access device in breast cancer patients undergoing chemotherapy.
This study aims to investigate the outcomes of the arm peripherally inserted central catheter-PORT technique in breast cancer patients. METHODS: The peripherally inserted central catheter-PORT technique is an evolution of the standard arm-totally implantable vascular access device implant based on guided ultrasound venous access in the proximal third of the upper limb with subsequent placement of the reservoir at the middle third of the arm. A prospective study was conducted on 418 adult female breast cancer patients undergoing chemotherapy. The primary study outcome was peripherally inserted central catheter-PORT fail...
Source: The Journal of Vascular Access - November 2, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Mini-midline in difficult intravenous access patients in emergency department: A prospective analysis.
CONCLUSION: The insertion of a mini-midline as part of the first emergency room visit in selected patients is a rapid, safe, and cost-effective procedure, which can provide the patient with stable venous access during the all hospitalization time. PMID: 31647353 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Preoperative noninvasive artery flow volume and maturation of arteriovenous fistulae: A single surgeon's experience from 403 cases.
Authors: Blessios G, Hlepas A, Diaz A Abstract BACKGROUND: Preoperative Doppler ultrasound evaluation of arteriovenous fistula inflow artery includes measurements of arterial diameter and flow volume. The purpose of this study was to evaluate the significance of flow volume to arteriovenous fistula maturation rate. STUDY DESIGN: Review of consecutive patients who underwent arteriovenous fistula creation by a single surgeon. Cases with available preoperative arterial diameter and flow volume were analyzed. Primary end point was arteriovenous fistula failure to mature. Information collected included demographics,...
Source: The Journal of Vascular Access - October 25, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Diaphragmatic fenestrations seen after peritoneal dialysis catheter placement: A rare cause of hydrothorax.
Authors: Black M, Arnold D, Mason D, Eidt J, Hohmann S Abstract This case report summarizes the clinical course of a patient who developed diaphragmatic fenestrations leading to hydrothorax after the initiation of peritoneal dialysis. We will discuss the interesting disease process in the setting of patient presentation, diagnosis, treatment, and outcome. PMID: 31621476 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Helical stent (SUPERA ™) and drug-coated balloon (Passeo-18 Lux™) for recurrent cephalic arch stenosis: Rationale and design of arch V SUPERA-LUX Study.
CONCLUSION: The Arch V SUPERA-LUX study is the first trial to evaluate whether SUPERA stent implantation and drug-coated balloon use can provide superior protection against restenosis compared to traditional angioplasty, bare metal stents and stent grafts in recurrent cephalic arch stenosis. Initial pilot results are encouraging but longer follow-up is required to truly test this technique. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov NCT03891693. PMID: 31621477 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Determinants of successful arteriovenous fistulae creation including intraoperative transit time flow measurement.
CONCLUSION: The predictive value of intraoperative flow measurement is superior to intraoperative physical examination and could help reduce the fistula dysmaturation rate. Intraoperative transit time flow measurement is an easy method and can be used to predict successful fistula maturation in a high percentage rate. PMID: 31621478 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Vascularization of the arteriovenous fistula wall and association with maturation outcomes.
In this study, we challenged the hypothesis that inadequate vascularization of the arteriovenous fistula wall is associated with maturation failure. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: This case-control pilot study includes pre-access veins and arteriovenous fistula venous samples (i.e. tissue pairs) from 30 patients undergoing two-stage arteriovenous fistula creation (15 matured and 15 failed to mature). Using anti-CD31 immunohistochemistry, we quantified vasa vasorum density and luminal area (vasa vasorum area) in the intima, media, and adventitia of pre-access veins and fistulas. We evaluated the associ...
Source: The Journal of Vascular Access - October 16, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Examination of nursing drug administration practices via central venous catheter: An observational study.
CONCLUSION: Observation of drug administration procedure steps via central venous catheter according to the treatment hours showed that the nurses performed many incomplete or inaccurate drug administration procedure steps and the mistakes increased toward the evening hours. PMID: 31612769 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 16, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Vascular endothelium damage from catheter-induced mechanical stimulation causes catheter sleeve formation in a rabbit model.
CONCLUSION: High levels of mechanical stimulation can affect catheter-related thrombosis and promote catheter sleeve formation, and anti-thrombogenic technology such as a poly(2-methoxyethyl acrylate) coating reduces thrombus formation and can prevent catheter sleeve formation on stiffened catheters. Further studies are required to determine the maximum degree of venous endothelial cell damage before catheter sleeve formation and to compare other anti-thrombogenic technologies with poly(2-methoxyethyl acrylate) for preventing catheter sleeve formation. PMID: 31591941 [PubMed - as supplied by publisher] (Source: The Jou...
Source: The Journal of Vascular Access - October 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Critical appraisal of a systematic review and meta-analysis comparing regional versus local anaesthesia for arteriovenous fistula creation.
Authors: Kobe I PMID: 31591943 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Comparison of drug-coated balloon angioplasty versus conventional angioplasty for arteriovenous fistula stenosis: Systematic review and meta-analysis.
CONCLUSION: Paclitaxel-coated balloon showed no statistically significant improvement over conventional balloons in decreasing fistula stenosis in randomized controlled trial but were significant for cohort studies. PMID: 31595799 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

A patient's decision aid for vascular access placement in the emergency department.
CONCLUSION: The result from this analysis indicated that most patients visiting the emergency department are not knowledgeable about their options related to vascular access device placement. The observed increase in the average correct responses on the post-test indicates that a patient decision aid can be an effective educational tool in the emergency department. PMID: 31595808 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Catheter-related thrombosis natural history in adult patients: a tale of controversies, misconceptions, and fears.
Authors: Pinelli F, Balsorano P Abstract Catheter-related thrombosis natural history understanding might play a pivotal role in the way we approach to symptomatic and asymptomatic events. At the moment, little is known about catheter-related thrombosis natural history in adult patients, where the fear for embolic events and thrombus extension often leads to a precautionary behavior as for screening and management. In adult population, the knowledge of the natural history of symptomatic and asymptomatic catheter-related thromboses can only be indirectly inferred by studies designed for other purposes. From the avail...
Source: The Journal of Vascular Access - October 9, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Effect of isometric handgrip exercise on the size of cephalic veins in patients with stage 3 and 4 chronic kidney disease: A randomized controlled trial.
Authors: Kumar A/L S Katheraveloo K, Suryani Safri L, Guo Hou L, Hafiz Maliki A, Md Idris MA, Harunarashid H Abstract BACKGROUND: Proper vascular access is essential for the long-term survival of chronic haemodialysis patients. The preferred vascular access in terms of long-term function is the native arteriovenous fistula. The success of native arteriovenous fistula depends mainly on a sufficient vein diameter. Thus, any intervention that could increase vein diameter before arteriovenous fistula creation could improve its patency. We conduct a study to investigate the effect of local physical training, namely hand...
Source: The Journal of Vascular Access - October 6, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Totally percutaneous endoluminal ballooning of stuck hemodialysis catheters: One-year experience of a referral center.
We presented a case series of five lines that were ballooned by navigating low-profile material directly from the cutaneous exit of the lines, with optimal results (100% success). The findings of this investigation provide additional evidence with respect to the safety and effectiveness of endoluminal ballooning of Tesio lines and offer a new variation of endoluminal ballooning which we found easy to perform, safe, and effective. PMID: 31580186 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 5, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Preoperative cephalic vein diameter and diabetes do not limit the choice of wrist radio-cephalic arteriovenous fistula.
CONCLUSION: Small cephalic vein diameter (
Source: The Journal of Vascular Access - October 5, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Two-year cumulative patency of endovascular arteriovenous fistula.
CONCLUSION: The proximal radial artery arteriovenous fistula created using an endovascular approach for the anastomosis is associated with excellent 2-year cumulative patency and is associated with a high level of patient satisfaction. PMID: 31566061 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 2, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Abstracts from the I International Congress on Vascular Access (CIAV), September 26-27, 2019, Coimbra, Portugal.
Authors: PMID: 31566075 [PubMed - in process] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - October 2, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Confirmation of central venous catheter placement in the presence of an ipsilateral arteriovenous fistula.
Authors: Kelly J, Aleksandrowicz D, Vargulescu R PMID: 31554455 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 28, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Current state of vascular access in Singapore.
This article described the current state of vascular access management for patients with end-stage renal disease in Singapore. Over the past 10 years, there has been a change in the demographics of end-stage renal disease patients. Aging population and the increase in prevalence of diabetes mellitus has led to the acceleration of chronic kidney disease and increase in incidence and prevalence of end-stage renal disease. Vascular access care has, therefore, been more complicated, with the physical, psychological, and social challenges that occur with increased frequency in elderly patients and patients with multiple ...
Source: The Journal of Vascular Access - September 28, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Kidney allograft dysfunction due to ipsilateral thigh arteriovenous graft.
Authors: Agrawal N, Garg N, Adapa S, Cardarelli F Abstract Arteriovenous graft in the thigh is used not infrequently for hemodialysis. Outcomes with this lower extremity dialysis access are generally comparable to upper extremity access and superior to long-term catheter use. However, it could have significant implications in a patient getting a kidney transplant. Here we describe a case of thigh arteriovenous graft causing kidney allograft dysfunction in a new transplant recipient, and this resolved with graft ligation. PMID: 31547759 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Comments on: Role of neutrophil-to-lymphocyte ratio as a prognostic indicator for hemodialysis arteriovenous fistula failure.
Authors: Akkaya G, Bilen Ç PMID: 31547762 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Failure to save (FTS): A proposed new index of performance quality in access surgery.
Authors: Lazarides MK, Baktiroglu S, Georgiadis GS PMID: 31547766 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis.
CONCLUSION: Incidence of phlebitis with the use of peripheral intravenous catheters during infusion is 31%. Severe phlebitis develops in 4% of all patients. Risk of phlebitis development can be reduced by adapting appropriate interventions. PMID: 31547791 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Cather-related right atrial thrombosis.
CONCLUSION: Catheter-related right atrial thrombosis is an underdiagnosed complication of central venous catheter placement. For the hemodialysis population, a fistula-first approach is advocated. While many instances were asymptomatic, the development of unexplained fever, dyspnea, catheter dysfunction, or new murmur should trigger a search for this complication. PMID: 31552793 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 26, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

The Surfacer ® Inside-Out® Access System for right-sided catheter placement in dialysis patients with thoracic venous obstruction.
CONCLUSION: The Surfacer System provides an efficient low-complexity alternative for gaining repeated right-sided central venous access in hemodialysis patients with obstructed thoracic veins. PMID: 31538859 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 22, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

An immediate access dialysis graft designed to prevent needle-related complications: Results from the initial pre-clinical studies.
We present the initial pre-clinical study results of a novel, self-sealing, immediate cannulation dialysis graft that aims to prevent needle-related complications; to promote safe, reliable needle access; to reduce catheter use; and could facilitate home hemodialyisis. METHODS: The innovative graft design consists of two cannulation chambers with self-sealing properties and materials that prevent side and back wall needle puncture. Study and control grafts (expanded polytetrafluoroethylene) were implanted in one pig and 10 sheep in two studies over the course of 1 year. First cannulation occurred immediately pos...
Source: The Journal of Vascular Access - September 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

If it looks like a catheter and winds like a catheter . . . fibroblastic sheath mimicking a central venous catheter fragment: A case report.
CONCLUSION: Three-dimensional computed tomography reconstruction, as well as the hollow appearance of a tubular structure after removal of a central catheter may help differentiate a fibroblastic sheath from a retained catheter fragment. Accurate surgical notes mentioning the length of the catheter at implant and explant are also of paramount importance. PMID: 31526092 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Recurrent central venous catheter migration in a patient with brittle asthma.
Authors: Hignell ER, Phelps J Abstract Central venous catheters are widely used in intensive care and critically unwell patients, and reporting of unusual complications is in the interest of those using them on a regular basis. Recognised complications involve vascular, cardiac and pulmonary systems and include the risk of infection. Described is a case with a recurrent complication of device failure secondary to migration of the central venous catheter tip as a result of recurrent coughing episodes. The approach to inserting central catheters and diagnosing the cause for the migration is discussed. This case direc...
Source: The Journal of Vascular Access - September 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Application of in-body tissue architecture-induced Biotube vascular grafts for vascular access: Proof of concept in a beagle dog model.
CONCLUSION: Within a short implantation period, with limited animal numbers, this proof-of-concept study showed that Biotubes may have a high potential for use in vascular access. PMID: 31530219 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 19, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Maturing arteriovenous accesses in incident haemodialysis patients and first-year outcomes.
Authors: McGill RL, Lacson EK Abstract INTRODUCTION: Nephrologists have increased arteriovenous access placement in patients with chronic kidney disease. Not yet usable 'maturing' arteriovenous fistulas and grafts are nearly as common as mature arteriovenous fistulas or grafts. Little has been reported about patients initiating haemodialysis with unready arteriovenous fistulas or grafts. METHODS: The United States Renal Data System records for all adult patients initiating haemodialysis with central venous catheters between July 2010 and December 2011. Patients were categorized by whether a maturing arterioveno...
Source: The Journal of Vascular Access - September 15, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

The electrocardiographic method for positioning the tip of central venous access device.
Authors: Yu Y, Yuan L Abstract BACKGROUND: The electrocardiogram-based insertion method is non-radiative, allowing real-time positioning verification and reducing the need for postoperative repositioning. METHODS: Relevant databases published from January 1990 to January 2019 in PubMed, Web of Knowledge, Medline and Ovid's database were searched, comparing the effectiveness of electrocardiogram-guided catheter tip positioning (electrocardiogram-guided group) and the landmarks-guided insertion plus chest X-ray confirmation (landmarks-guided group). The primary outcome was accurate catheter tip placement and the ...
Source: The Journal of Vascular Access - September 14, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

High success rate in salvage of catheter-related bloodstream infections due to Staphylococcus aureus, on behalf of project group of Italian society of nephrology.
CONCLUSION: Our data lead us to believe that it is possible to successfully treat catheter-related bloodstream infection caused by S. aureus and to avoid removing the tunnelled central venous catheter in many more cases than what has been reported in the literature. On the third day, it is mandatory to decide whether to replace the tunnelled central venous catheter or to carry on with antibiotic therapy. Apyrexia and amelioration of laboratory parameters suggest continuing systemic and antibiotic lock therapy for no less than 4 weeks, otherwise, tunnelled central venous catheter removal is recommended. PMID: 31512986 [...
Source: The Journal of Vascular Access - September 14, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Jury verdicts and outcomes of malpractice cases involving arteriovenous hemodialysis access.
CONCLUSION: While popular opinion may indicate that steal syndrome is a commonly litigated complication, our data reveal that the most common injury litigated is death which may frequently be the result of a hemorrhagic episode. In addition to hemorrhage, the remaining most common complications included steal syndrome and loss of limb function. Therefore, steps to better prevent, diagnose and treat bleeding, nerve injury, and steal syndrome in a timely manner are critical to preventing hemodialysis-access-associated litigation. PMID: 31495258 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

Hemodialysis access cost comparisons among incident tunneled catheter patients.
Authors: Wagner JK, Fish L, Weisbord SD, Yuo TH Abstract BACKGROUND: Arteriovenous fistula is the ideal hemodialysis access, but most patients start with tunneled dialysis catheter. Arteriovenous fistula and arteriovenous graft surgery may reduce tunneled dialysis catheter use and also increase procedural expenses. We compared Medicare costs associated with arteriovenous fistula, arteriovenous graft, and tunneled dialysis catheter. METHODS: Using the US Renal Data System, we identified incident hemodialysis patients in 2008 who started with tunneled dialysis catheter, survived at least 90 days, and had a...
Source: The Journal of Vascular Access - September 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research

An innovative cyanoacrylate device developed to improve the current standard of care for intravascular catheter securement.
CONCLUSION: This is one of the first studies to provide quantitative data to support the use of cyanoacrylate for intravascular catheter securement. The results from this research suggest that the novel catheter securement cyanoacrylate can be a simple and cost-effective catheter securement device that can improve the current health care protocol for intravascular catheterization. PMID: 31495268 [PubMed - as supplied by publisher] (Source: The Journal of Vascular Access)
Source: The Journal of Vascular Access - September 11, 2019 Category: Surgery Tags: J Vasc Access Source Type: research