Choice of vascular access in patients undergoing haemodialysis: Cimino-brescia arteriovenous fistula remains the first choice and central venous catheter the last

2012 ◽  
Vol 84 (4) ◽  
pp. 243-247
Author(s):  
I. Kotsikoris ◽  
Th. Papas ◽  
D. Maras ◽  
P. Pavlidis ◽  
N. Papanas ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Central Venous ◽  
First Choice

Aneurysm of Arteriovenous Fistula in Uremic Patients: Is Endograft a Viable Therapeutic Approach?

2002 ◽  
Vol 3 (2) ◽  
pp. 85-88 ◽  
Author(s):  
P.M. Allaria ◽  
E. Costantini ◽  
A. Lucatello ◽  
E. Gandini ◽  
F. Caligara ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Good Alternative ◽  
Central Venous ◽  
Arteriovenous Fistulas ◽  
Risk Of Rupture ◽  
Arterial Aneurysms ◽  
Percutaneous Insertion

One of the complications of arteriovenous fistulas in chronic hemodialyzed patients is the onset of an aneurysm which can be at risk of rupture. Traditional surgical repair is not always feasible and may not be successful in these cases, leading therefore to the loss of a functioning vascular access and requiring in any case the temporary use of a central venous catheter to allow regular hemodialysis sessions. We applied to this kind of aneurysm the same experience developed in the management of major arterial aneurysms and we considered endografting repair a good alternative in this case. In this paper we present the successful treatment of an arteriovenous fistula aneurysm using that technique. A distal radio-cephalic arteriovenous fistula in one of our patients presented an aneurysm with high risk of rupture. The endografting repair with percutaneous insertion of a Wallgraft™ endoprosthesis was well tolerated and the vascular access could be used the day after, without the need for a central venous catheter insertion.

Vascular access for chronic hemodialysis in children: arteriovenous fistula or central venous catheter?

2014 ◽  
Vol 29 (12) ◽  
pp. 2395-2401 ◽  
Author(s):  
Aicha Merouani ◽  
Michel Lallier ◽  
Julie Paquet ◽  
Johanne Gagnon ◽  
Anne Laure Lapeyraque
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Chronic Hemodialysis ◽  
Central Venous

American Association of Kidney Patients survey of patient preferences for hemodialysis vascular access

2019 ◽  
Vol 21 (2) ◽  
pp. 230-236
Author(s):  
Saravanan Balamuthusamy ◽  
Larry E Miller ◽  
Diana Clynes ◽  
Erin Kahle ◽  
Richard A Knight ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
American Association ◽  
Venous Catheter ◽  
Central Venous ◽  
Stage Renal Disease ◽  
End Stage

Objectives: To determine the vascular access modalities used for hemodialysis, the reasons for choosing them, and determinants of satisfaction with vascular access among patients with end-stage renal disease. Methods: The American Association of Kidney Patients Center for Patient Research and Education used the American Association of Kidney Patients patient engagement database to identify eligible adult hemodialysis patients. Participants completed an online survey consisting of 34 demographic, medical history, and hemodialysis history questions to determine which vascular access modalities were preferred and the reasons for these preferences. Results: Among 150 respondents (mean age 54 years, 53% females), hemodialysis was most frequently initiated with central venous catheter (64%) while the most common currently used vascular access was arteriovenous fistula (66%). Most (86%) patients previously received an arteriovenous fistula, among whom 77% currently used the arteriovenous fistula for vascular access. Older patients and males were more likely to initiate hemodialysis with an arteriovenous fistula. The factors most frequently reported as important in influencing the selection of vascular access modality included infection risk (87%), physician recommendation (84%), vascular access durability (78%), risk of complications involving surgery (76%), and impact on daily activities (73%); these factors were influenced by patient age, sex, and race. Satisfaction with current vascular access was 90% with arteriovenous fistula, 79% with arteriovenous graft, and 67% with central venous catheter. Conclusion: Most end-stage renal disease patients continue to initiate hemodialysis with central venous catheter despite being associated with the lowest satisfaction rates. While arteriovenous fistula was associated with the highest satisfaction rate, there are significant barriers to adoption that vary based on patient demographics and perception of procedure invasiveness.

scholarly journals Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

Kidney360 ◽  
2020 ◽  
Vol 1 (11) ◽  
pp. 1259-1269
Author(s):  
Yong Pey See ◽  
Yeoungjee Cho ◽  
Elaine M. Pascoe ◽  
Alan Cass ◽  
Ashley Irish ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Controlled Trial ◽  
Laboratory Data ◽  
Venous Catheter ◽  
Central Venous ◽  
Factors Associated ◽  
Female Sex ◽  
Post Hoc

BackgroundAn autologous arteriovenous fistula (AVF) is the preferred hemodialysis vascular access, but successful creation is hampered by high rates of AVF failure. This study aimed to evaluate patient and surgical factors associated with AVF failure to improve vascular access selection and outcomes.MethodsThis is a post hoc analysis of all participants of FAVOURED, a multicenter, double-blind, multinational, randomized, placebo-controlled trial evaluating the effect of fish oil and/or aspirin in preventing AVF failure in patients receiving hemodialysis. The primary outcome of AVF failure was a composite of fistula thrombosis and/or abandonment and/or cannulation failure at 12 months post-AVF creation, and secondary outcomes included individual outcome components. Patient data (demographics, comorbidities, medications, and laboratory data) and surgical factors (surgical expertise, anesthetic, intraoperative heparin use) were examined using multivariable logistic regression analyses to evaluate associations with AVF failure.ResultsOf 536 participants, 253 patients (47%) experienced AVF failure during the study period. The mean age was 55±14.4 years, 64% were male, 45% were diabetic, and 4% had peripheral vascular disease. Factors associated with AVF failure included female sex (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.20 to 2.68), lower diastolic BP (OR for higher DBP, 0.85; 95% CI, 0.74 to 0.99), presence of central venous catheter (OR, 1.49; 95% CI, 1.02 to 2.20; P=0.04), and aspirin requirement (OR, 1.60; 95% CI, 1.00 to 2.56).ConclusionsFemale sex, requirement for aspirin therapy, requiring hemodialysis via a central venous catheter, and lower diastolic BP were factors associated with higher odds of AVF failure. These associations have potential implications for vascular access planning and warrant further studies.

The association between vascular access type and depressive symptoms in geriatric hemodialysis population

Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 390-395
Author(s):  
Betul Nur Keser ◽  
Ulku Nur Kirman ◽  
Cemal Kocaaslan ◽  
Ebuzer Aydin
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Multiple Logistic Regression Analysis ◽  
Depression Scale ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous

Objectives A well-functioning vascular access is crucial for hemodialysis treatment, and arteriovenous fistula is the recommended vascular access type. Arteriovenous fistula is superior to other vascular access types in many aspects, but the effect of arteriovenous fistula on patients’ psychiatric state is not well described yet. The aim of this study is to determine whether there is an association between vascular access type and depression scores. Methods This cross-sectional study was conducted at two hemodialysis centers. Geriatric Depression Scale-15 was administered to geriatric hemodialysis patients, using ≥5 score as the cut-off value for the presence of depressive symptoms. Descriptive tests, Kolmogorov–Smirnov test, Pearson’s Chi-square test, Mann–Whitney test, Kruskal–Wallis test, Spearman’s rank correlation calculation, and multiple logistic regression analysis were performed accordingly to analyze the data. Results Of 75 participants, 34 (45.3%) were female and the mean age was 73.4 ± 5.9 years (range: 65–92). The prevalence of depressive symptoms in the geriatric hemodialysis population was 53.3%. Central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for higher depression scores (aOR 10.505 (95% CI 1.435–76.900), p = 0.021; aOR 9.783 (95% CI 2.508–38.169), p = 0.001; aOR 1.019 (95% CI 1.003–1.035), p = 0.017, respectively). Among patients with arteriovenous fistula, those with hypertension had higher depression scores ( p = 0.008). Conclusions Geriatric hemodialysis patients were found to have depressive symptoms commonly, and central venous catheter, hypertension, and increased time on hemodialysis have been found to be risk factors for presence of depressive symptoms. To the best of our knowledge, this is the first study highlighting that arteriovenous fistula is associated with lower depression scores and lower prevalence of depressive symptoms.

Hemodynamics Alterations Induced by Central Venous Catheter in Vascular Access for Hemodialysis

2021 ◽  
Author(s):  
Saulo Gonçalves ◽  
Mário Silva ◽  
Matheus Costa ◽  
Thabata Lucas ◽  
Rudolf Huebner
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Venous Catheter ◽  
Central Venous

Timing of referral for vascular access for hemodialysis: Analysis of the current status and the barriers to timely referral

2019 ◽  
Vol 20 (6) ◽  
pp. 659-665
Author(s):  
Suh Min Kim ◽  
Ahram Han ◽  
Sanghyun Ahn ◽  
Sang-il Min ◽  
Jongwon Ha ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Venous Catheter ◽  
Current Status ◽  
Rapid Progression ◽  
Central Venous ◽  
Progression Of Kidney Disease ◽  
Current Guidelines ◽  
Timely Referral ◽  
Late Referral

Introduction: Current guidelines recommend the placement of vascular access 6 months before the anticipated start of hemodialysis therapy; however, many patients start hemodialysis using a central venous catheter. We investigated the timing of referral for vascular access, the vascular access type at hemodialysis initiation, and the barriers to a timely referral. Methods: The study involved a retrospective review of 237 patients for whom the first vascular access for hemodialysis was created between January and November 2017. Results: Among the 237 patients, 58.2% were referred before hemodialysis initiation, while 41.8% were referred after hemodialysis initiation. Among the 138 patients, 55, 59, and 24 patients were referred more than 6 months, between 2 and 6 months, and within 2 months before hemodialysis initiation, respectively. Within these subgroups, 3.6%, 10.2%, and 75.0% patients underwent hemodialysis initiation with a central venous catheter, respectively. Among the 99 patients referred after hemodialysis initiation, the reasons for late referral were as follows: unexpected rapid progression of kidney disease (n = 23), noncompliance (n = 21), late visit to the nephrologist (initial visit within 2 months of hemodialysis initiation; n = 14), change of treatment strategy from peritoneal dialysis or transplants (n = 9), and unknown reasons (n = 32). Conclusion: Only 23% of patients were referred for vascular access 6 months before the anticipated hemodialysis therapy. In addition, 53% of patients initiated hemodialysis with a central venous catheter. Avoidance of catheter insertion was mostly successful in patients referred 2 months before hemodialysis initiation. The most common modifiable barrier to the timely referral was noncompliance.

Clinical Performance of a New Transparent Chlorhexidine Gluconate Central Venous Catheter Dressing

2008 ◽  
Vol 13 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Carol Olson ◽  
James M. Heilman
Keyword(s):  
Health Care ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
New Technologies ◽  
Insertion Site ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Ease Of Use ◽  
Central Venous ◽  
Or Education

Abstract As the sciences of vascular access and infection prevention rapidly advance healthcare professionals are often faced with new technologies designed to help, but which are often so complicated to use that they cause unforeseen problems. As a vascular access team at a major mid-western hospital, we evaluated the ease-of-use and the performance characteristics of a new transparent catheter dressing, 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) containing the antimicrobial chlorhexidine gluconate (CHG), with a variety of central venous catheters insertion sites in comparison to a standard non-antimicrobial dressing Tegaderm® (3M Health Care™, St. Paul, MN). Following IRB approval, sixty-three consenting patients were enrolled and randomized; 33 in the CHG antimicrobial dressing group and 30 in the standard dressing group. Thirty six patients had peripherally inserted central catheters (PICCs), 20 had intrajugular insertions (IJ), and 7 had subclavian insertions. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was evaluated for its ability to permit visualization of the insertion site, ease of use, ease of using correctly, ability to secure the catheter and absorb exudates and remain transparent. The new 3M Tegaderm CHG IV Securement Dressing® (3M Health Care™, St. Paul, MN) was found to be as easy to use in central venous catheter care clinical practice as the standard of care non-antimicrobial transparent adhesive dressing. No additional training or education was required to properly use it. This dressing was applied and removed like standard transparent adhesive dressings, but offered many advantages over standard dressings. Advantages include that it is antimicrobial, handles moderate bleeding, remains transparent and appears to offer greater catheter securement than the Tegaderm® (3M Health Care™, St. Paul, MN) standard dressing. The CHG gel pad also conformed well to the catheter.

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