scholarly journals Patient characteristics predict patency of early-cannulation arteriovenous grafts

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
David B. Kingsmore ◽  
Karen S. Stevenson ◽  
S. Richarz ◽  
Andrej Isaak ◽  
Andrew Jackson ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Vascular Access ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Patient Characteristics ◽  
Peripheral Vascular ◽  
Arteriovenous Grafts ◽  
One Year

AbstractThere is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly, strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.

scholarly journals Patient Characteristics Predict Patency of Early-Cannulation Arteriovenous Grafts

2020 ◽  
Author(s):  
David Kingsmore ◽  
Karen Stevenson ◽  
Sabine Richarz ◽  
Andrej Isaak ◽  
Andrew Jackson ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Vascular Access ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Patient Characteristics ◽  
Peripheral Vascular ◽  
Arteriovenous Grafts ◽  
One Year

Abstract There is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.

Acute pain in peripheral vascular disease

2011 ◽  
Author(s):  
Arif H. Ghazi ◽  
Obi Agu
Keyword(s):  
Pain Relief ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Pain ◽  
Peripheral Vascular ◽  
Surgical Revascularization ◽  
End Stage

Pain in vascular disease is often severe. Atherosclerosis is the commonest cause of ischaemic pain. Angioplasty, stents, and surgical revascularization should be attempted to treat the underlying cause. Pain relief is also aimed at neuropathic and sympathetic components of pain. In end stage ischaemic disease, amputation may be necessary often leading to long-term pain.

The Behaviour of Various Platelet Function Tests During Long-Term Prostacyclin Infusion in Patients with Peripheral Vascular Disease

1983 ◽  
Vol 50 (04) ◽  
pp. 885-887 ◽  
Author(s):  
H Sinzinger ◽  
A K Horsch ◽  
K Silberbauer
Keyword(s):  
Platelet Count ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Platelet Function ◽  
Peripheral Vascular ◽  
Platelet Function Tests ◽  
Function Tests ◽  
Induced Aggregation ◽  
Significant Activation

SummaryIn 20 patients with peripheral vascular disease treated with prostacyclin (5 ng/kg/min) we observed a significant activation of platelet function as measured by platelet proteins, ADP- induced aggregation platelet sensitivity and platelet count. Only the platelet survival was significantly prolonged by the treatment.

Peripheral vascular disease and/or need for dialysis predicts mortality in acute myocardial infarction with shock treated with mechanical circulatory support

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Ortiz ◽  
G Stouffer ◽  
J Rossi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Prior History ◽  
Peripheral Vascular ◽  
One Year

Abstract Background Acute myocardial infarction (AMI) with left ventricular systolic dysfunction remains the largest cause for cardiogenic shock (CS) admissions. Aside for prompt revascularization few therapies have been shown to improve survival in this patient population. In the last decade, the use of mechanical circulatory support devices (MCS) for CS has increased, despite little evidence guiding their use. Purpose To explore for different baseline factors which may favor treatment with MCS vs pharmacological circulatory support (PCS) in AMI related CS. Methods Baseline clinical and procedural variables were retrospectively collected for all patient presenting to the cardiac cath lab with an AMI and CS at a large health care system. Patients were stratified by whether they received MCS or only PCS. The outcomes of interest were 30 day and one year mortality. Results Between 01/2014 andv08/2018, 205 patients presented to the cath lab with an AMI complicated by CS. The vast majority of cases were STEMIs (133/205, 65%). Overall mortality for the cohort at 30 days and one year were 41% and 50% respectively. There was no difference in 30 day or 1 year mortality between the MCS and PCS groups. A STEMI presentation was associated with increase 30 day mortality in the MCS group but the association was not seen at one year. Interestingly having a prior history peripheral vascular disease (PVD) and/or being on dialysis prior to the procedure was predictive of one year mortality in the MCS group (OR 3.8, 1.4–10.6, p=0.006) but not in the PCS. Conclusion Patients presenting with AMI complicated by CS have a high mortality despite successful revascularization. In our cohort having PVD and/or needing dialysis was predictive of mortality in patients receiving MCS. Patient selection is an important factor in choosing appropriate circulatory support, further prospective studies are needed. Figure 1 Funding Acknowledgement Type of funding source: None

Long-Term Follow-up of Syme Amputations for Peripheral Vascular Disease Associated with Diabetes Mellitus

Foot & Ankle ◽  
1988 ◽  
Vol 9 (3) ◽  
pp. 107-110 ◽  
Author(s):  
Richard S. Jany ◽  
J. Kenneth Burkus
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Surgical Wounds ◽  
Surgical Incisions ◽  
Long Term Follow Up ◽  
Successful Clinical Outcome ◽  
Clinical Records

Ten patients underwent Syme amputation for diabetic peripheral vascular disease between 1980 and 1986 and were observed postoperatively for an average of 5 years. Surgical wounds healed in only five of the 10 patients; they were then fitted for a permanent Syme's prosthesis. All failures resulted from the inability to heal the surgical incisions primarily. The clinical records of these patients were retrospectively analyzed for predictors of successful clinical outcome. The ischemic index, grade of the lesion, initial wound treatment, and presence of the infection at the time of amputation were not found to be reliable predictors of a successful level of amputation. Clinical assessment of both the vascular and nutritional status of the patient was necessary to predict a successful result at this level of amputation.

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