scholarly journals FP574A MODERN CHALLENGE FOR NEPHROLOGISTS VASCULAR ACCESS SURVEILLANCE IN THE HEMODIALYSIS UNIT. IMPACT OF AN INTENSIVE ULTRASOUND SURVEILLANCE PROTOCOL PERFORMED BY NEPHROLOGISTS IN ARTERIOVENOUS FISTULAE AND ARTERIOVENOUS GRAFT PATENCY RATES

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i234-i234
Author(s):  
Ioannis Giannikouris ◽  
Chrysostomos Konstantos ◽  
Velissarios Gkinis ◽  
Fotini Alevizaki ◽  
Rania Karabogia ◽  
...  
Keyword(s):  
Vascular Access ◽  
Graft Patency ◽  
Arteriovenous Graft ◽  
Arteriovenous Fistulae ◽  
Hemodialysis Unit ◽  
Surveillance Protocol ◽  
Ultrasound Surveillance

Reduction in arteriovenous graft impairment: Results of a vascular access surveillance protocol

1998 ◽  
Vol 32 (2) ◽  
pp. 302-308 ◽  
Author(s):  
AV Cayco ◽  
AK Abu-Alfa ◽  
RL Mahnensmith ◽  
MA Perazella
Keyword(s):  
Vascular Access ◽  
Arteriovenous Graft ◽  
Surveillance Protocol

scholarly journals Role of Doppler ultrasonography in the evaluation of hemodialysis arteriovenous access maturation and influencing factors

2021 ◽  
pp. 112972982096506
Author(s):  
Eva Chytilova ◽  
Tamara Jemcov ◽  
Jan Malik ◽  
Jernej Pajek ◽  
Branko Fila ◽  
...  
Keyword(s):  
Vascular Access ◽  
Doppler Ultrasonography ◽  
Arteriovenous Graft ◽  
Central Venous ◽  
Preoperative Mapping ◽  
High Incidence ◽  
Arteriovenous Access ◽  
Ultrasound Parameters ◽  
Fistula Maturation

The goal of vascular access creation is to achieve a functioning arteriovenous fistula (AVF) or arteriovenous graft (AVG). An autologous fistula has been shown to be superior to AVG or to central venous catheters (CVCs) with lowest rate of re-intervention, but vessel obstruction or immaturity accounts for 20 % to 54% of cases with primary failure of AVF. This review is focused on the factors influencing maturation; indication and timing of preoperative mapping/creation of vascular access; ultrasound parameters for creation AVF/AVG; early postoperative complications following creation of a vascular access; ultrasound determinants of fistula maturation and endovascular intervention in vascular access with maturation failure. However, vascular accesses that fail to develop, have a high incidence of correctable abnormalities, and these need to be promptly recognized by ultrasonography and managed effectively if a high success rate is to be expected. We review approaches to promoting fistula maturation and duplex ultrasonography (DUS) of evaluating vascular access maturation.

Arteriovenous graft patency outcomes and prognostic factors

Vascular ◽  
2018 ◽  
Vol 27 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Jeeeun Park ◽  
Jinhae Kim ◽  
Subin Hwang ◽  
Mi Kyoung Lee ◽  
Hye Ryoun Jang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prognostic Factors ◽  
Serum Albumin ◽  
Diastolic Blood Pressure ◽  
Laboratory Data ◽  
Graft Patency ◽  
Primary Patency ◽  
Hemoglobin Level ◽  
Secondary Patency ◽  
Arteriovenous Graft

Objectives Arteriovenous graft for hemodialysis shows poorer outcomes than arteriovenous fistula, due to frequent stenosis and thrombosis. We investigated arteriovenous graft patency outcomes and prognostic factors for these outcomes. Methods We included a single-center cohort of patients receiving arteriovenous graft for hemodialysis access from 2010 to 2014. Demographics, laboratory data, comorbidities, and medications were collected from medical records. Surgical factors related to graft operation including the type and diameter of connected vessels, graft location, and type of operation (elective or emergency) were also recorded. Outcomes included primary and secondary patency. Survival analysis was conducted using the Kaplan-Meier method; univariate and multivariate analyses were used to evaluate the prognostic factors. Results Data from 225 grafts were analyzed. During the follow-up period (mean: 583 days, range: 1–1717 days), 138 (61%) grafts required intervention and 46 (20%) permanently failed. Primary patency at one, two, and three years was 42%, 20%, and 16%, respectively. Secondary patency at one, two, and three years was 85%, 72%, and 64%, respectively. Multivariate analysis showed that primary patency was negatively associated with increasing age and location of vessel anastomosis (reference-brachiobrachial anastomosis; brachiobasilic – HR, 0.569; 95% CI, 0.376–0.860; p = 0.007; brachioaxillary anastomosis – HR 0.407; 95% CI, 0.263–0.631; p < 0.0001); secondary patency was positively associated with diastolic blood pressure, serum albumin level, and hemoglobin over 10 g/dL. Adverse events other than stenosis or thrombosis, such as infection/inflammation or pseudoaneurysm were observed in approximately 20% of grafts. Conclusions Factors associated with diminished primary arteriovenous graft patency included increased patient age and location of vessel anastomosis (brachiobrachial type compared to brachiobasilic or brachioaxillary type); diminished secondary patency was associated with low diastolic blood pressure, low serum albumin, and hemoglobin level under 10 g/dL. Among these factors, diastolic blood pressure, serum albumin, and hemoglobin level may be modifiable and could improve arteriovenous graft patency outcomes.

Effect of Adventitial Dissection in Brachiobasilic Arteriovenous Fistulae Opened in Children as Vascular Access for Hemodialysis on Patency and Maturation of Fistulae

2004 ◽  
Vol 52 (05) ◽  
pp. 330 ◽  
Author(s):  
Ozalp Karabay ◽  
Mustafa Bak ◽  
Erdem Silistreli ◽  
Sebnem Calkavur ◽  
Ismail Yurekli ◽  
...  
Keyword(s):  
Vascular Access ◽  
Arteriovenous Fistulae

scholarly journals MP661ARTERIOVENOUS FISTULA AND ARTERIOVENOUS GRAFT FOR VASCULAR ACCESS IN HAEMODIALYSIS - A RETROSPECTIVE COHORT STUDY

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii674-iii674
Author(s):  
Rachele Escoli ◽  
Ivan Luz ◽  
Hernani Gonçalves ◽  
Paulo Santos ◽  
Ana Vila Lobos
Keyword(s):  
Cohort Study ◽  
Vascular Access ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Arteriovenous Graft

Introducing a “no-touch” maneuver to manage challenging anastomoses in arteriovenous fistulae

2020 ◽  
pp. 112972982096839
Author(s):  
Efstratios Georgakarakos ◽  
Kalliopi-Maria Tasopoulou ◽  
George S Georgiadis
Keyword(s):  
Surgical Technique ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Surgical Outcome ◽  
Dialysis Patients ◽  
Synthetic Graft ◽  
Arteriovenous Fistulae ◽  
Feeding Tubes

Native arteriovenous fistula or interposition of a synthetic graft for vascular access is crucial for dialysis patients. Optimal surgical technique, microsurgery instrumentation and preventive hemostasis are considered beneficial for a successful surgical outcome. We describe a simple and novel maneuver using soft-feeding tubes to facilitate the manipulation of veins and perform successful anastomoses without using microsurgery instrumentation or vascular clamps during operations for vascular access.

Catheter-related obstruction of the right brachiocephalic vein following hemodialysis in a patient with lupus nephritis

2020 ◽  
pp. 112972982092608
Author(s):  
Mitsutoshi Shindo ◽  
Kenichi Oguchi ◽  
Chihiro Kimikawa ◽  
Kiyonori Ito ◽  
Jyunki Morino ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Axillary Vein ◽  
Arteriovenous Graft ◽  
Complete Obstruction ◽  
Hemodialysis Catheter ◽  
The Right

Vascular access is necessary for hemodialysis, and in some cases where it is difficult to establish an arteriovenous fistula or arteriovenous graft, a permanent hemodialysis catheter may be used. However, serious catheter-related complications, such as central vein stenosis or thrombosis, can occur. We herein present a case of complete brachiocephalic vein obstruction in a patient with lupus nephritis receiving hemodialysis using a tunneled hemodialysis catheter. A 64-year-old patient underwent maintenance hemodialysis while taking an anticoagulant, with a tunneled hemodialysis catheter in the right internal jugular vein, because of arteriovenous fistula failure when hemodialysis was introduced. However, the catheter was removed because of a catheter-related bloodstream infection. Following the administration of antibiotics, an arteriovenous graft was implanted between the brachial artery and axillary vein in the right arm. Surprisingly, arteriovenous graft failure and complete obstruction of the right brachiocephalic vein were observed 3 days after arteriovenous graft creation. In conclusion, we report the case of tunneled hemodialysis catheter-related complete obstruction of the right brachiocephalic vein in a lupus nephritis patient undergoing hemodialysis. Clinicians should be aware of this potential complication when tunneled hemodialysis catheters are used and consider the next vascular access type before a tunneled hemodialysis catheter has been indwelled for the long term.

Managing anxiety during arteriovenous fistula or arteriovenous graft needling

2019 ◽  
Vol 4 (4) ◽  
pp. 205-210
Author(s):  
Lynsey Stronach ◽  
Simone Friedl ◽  
Carmen Barton ◽  
Cora Lahart ◽  
Yvie Morley
Keyword(s):  
Young Adults ◽  
Young People ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Arteriovenous Graft ◽  
Children And Young People ◽  
Children And Young Adults

Vascular access is crucial for haemodialysis, but cannulation of an arteriovenous fistula can be anxiety-provoking for patients, particularly children and young people. This article outlines the management and treatment of needle-related anxiety and pain for children and young adults

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