Latis™ Catheter: New Technology for Thrombectomy of Vascular access Grafts

2003 ◽  
Vol 4 (3) ◽  
pp. 118-122
Author(s):  
A.F. Schild ◽  
N.M. Baltodano ◽  
R. Elias ◽  
J. Livingstone ◽  
J. Raines
Keyword(s):  
Vascular Access ◽  
New Technology ◽  
Statistical Significance ◽  
Primary Patency ◽  
Rank Statistic ◽  
P Value ◽  
Vascular Access Surgery ◽  
Residual Thrombus ◽  
Number Of Passes ◽  
Access Surgery

Purpose The most common complication of vascular access surgery is thrombosis. This study compared the gold standard Fogarty Thrombectomy Catheter, to the new latis Catheter with an advanced monofilament matrix. Methods 30 patients with thrombosed access grafts were randomly assigned to undergo thrombectomy with the Fogarty or latis catheter. An angioscope measured remaining graft thrombi. Results Twenty-nine of 30 subjects were successfully thrombectomized. No statistical differences in age, gender, race, or extension graft requirements were found. Catheter use in the latis group was: 1 in 14 procedures, and 2 in 1 procedure; Fogarty group: 1 in 10 procedures, 2 in 3 procedures, and 3 in 2 procedures. The average number of catheter passes was: latis 3.06 (1–6 passes) and Fogarty 4.13 (1–9 passes). A trend in favor of the latis catheter was demonstrated; however, statistical significance was not reached (p = 0.067). The overall 6-month primary patency rates were latis (40%) and Fogarty (30%). The estimated patency at the 50th percentile for latis is 120 days and Fogarty 108 days. Statistical significance was not reached with a p-value of the Log-Rank statistic of 0.68 and a p-value of the Wilcoxon statistic of 0.78. Conclusions The latis and Fogarty catheters are very similar. However, the latis balloon is more rugged with fewer catheters used and reduced number of passes. A difference in primary patency could not be demonstrated. The angioscope identified significant residual thrombus despite no returning thrombus from the catheter. Consequently, our protocol is modified to include the angioscope.

The Role of Routine Angioscopy in Vascular Access Surgery

1995 ◽  
Vol 2 (1) ◽  
pp. 10-25 ◽  
Author(s):  
Thomas J. Hölzenbein ◽  
Arnold Miller ◽  
Michael N. Gottlieb ◽  
Sushil K. Gupta
Keyword(s):  
Vascular Access ◽  
Vascular Access Surgery ◽  
Access Surgery

Care pathway reduces hospitalizations and cost for hemodialysis vascular access surgery

1997 ◽  
Vol 30 (4) ◽  
pp. 525-531 ◽  
Author(s):  
Bryan N. Becker ◽  
Randee Breiterman-White ◽  
William Nylander ◽  
David Van Buren ◽  
Chris Fotiadis ◽  
...  
Keyword(s):  
Vascular Access ◽  
Care Pathway ◽  
Vascular Access Surgery ◽  
Hemodialysis Vascular Access ◽  
Access Surgery

MO775CONTROL OF BONE DISEASE ASSOCIATED WITH CHRONIC KIDNEY DISEASE AS A PREDICTOR OF PRIMARY PERMEABILITY AFTER THE CREATION OF THE VASCULAR ACCESS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Luis Guillermo Piccone Saponara ◽  
Maria Paz Castro Fernández ◽  
Nancy Giovanna Uribe Heredia ◽  
Agustin Carreno ◽  
Sara Anaya Fernandez ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Vascular Access ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Primary Patency ◽  
Categorical Variables ◽  
Cross Sectional ◽  
High Phosphorus ◽  
The Creation ◽  
Phosphorus Levels

Abstract Background and Aims Clinical practice guidelines recommend an arteriovenous fistula (AVF) as the preferred vascular access for hemodialysis. Patency of the arteriovenous access is important for effective hemodialysis. However, maintaining the patency of the AVF remains a challenge. We determined those independent prognostic factors for the patency of the AVF at the time of its creation. Method Cross-sectional study; We include all AVFs performed at the HGUCR in the last 2 decades. Demographic variables (age, sex), etiology of CKD and associated comorbidity were collected. We determine the factors involved in the primary patency of AVFs. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and are compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the Mann Whitney Student-T/U was used to compare them. Statistical significance for a value of p <0.05. Results 622 AVFs performed in 482 patients were reviewed. 86.8% were autologous. The mean age was 65.4±14 years; 66.6% were male. The most frequent etiologies of CKD were diabetic nephropathy (30.2%), unknown (18%), and glomerulonephritis (16.6%). 91.2% had arterial hypertension (HBP) and diabetes mellitus (DM) 47.9%. 48.7% received antiplatelet therapy and 15.6% anticoagulation prior to the creation of the AVF. 27% presented primary failure. The univariate analysis showed statistical significance for the qualitative variables HTA (p=0.002), treatment with statins (p<0.01) and antiplatelet (p<0.01), and for the quantitative variables fibrinogen (p=0.048), serum phosphorus (p=0.001), CRP (p=0.004), triglycerides (p=0.05), ferritin (p=0.006) and age (p=0.05). When performing a multivariate analysis using logistic regression, HTA (OR: 0.46 95% CI 0.22-0.95 p = 0.036), high phosphorus levels (OR: 1.22 95% CI 1.08-1, 49 p = 0.004) and statin treatment (OR: 0.58 95% CI 0.36-0.96 p = 0.004) are predictors of primary VA failure. Conclusion In our study, HTA and antiplatelet therapy prior to the creation of the VA behave as protective factors for primary failure, with high phosphorus levels being an independent factor for primary failure of AVFs.

Current techniques for permanent vascular access surgery — experience with 930 procedures

1991 ◽  
pp. 237-245
Author(s):  
S. Al-Dadah ◽  
M. Kalawi ◽  
M. Samhan ◽  
P. John ◽  
M. S. A. Kumar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Vascular Access Surgery ◽  
Access Surgery

Anesthesia for Vascular access Surgery

2014 ◽  
Vol 15 (7_suppl) ◽  
pp. 38-44 ◽  
Author(s):  
David Shemesh ◽  
Yefim Raikhinstein ◽  
Dina Orkin ◽  
Ilya Goldin ◽  
Oded Olsha
Keyword(s):  
Vascular Access ◽  
Vascular Access Surgery ◽  
Access Surgery

scholarly journals Training vascular access surgeons: technicians or specialists?

2018 ◽  
Vol 19 (2) ◽  
pp. 117-118
Author(s):  
Nicholas Inston ◽  
Tej M. Singh
Keyword(s):  
Surgical Training ◽  
Vascular Access ◽  
Vascular Access Surgery ◽  
Technical Aspects ◽  
Knowledge And Skills ◽  
Traditional Training ◽  
Access Surgery ◽  
Future Practice ◽  
And Training

Internationally, vascular access (VA) surgery is delivered in a varied and diverse fashion and subsequently, training in vascular access is poorly defined. Experience of VA during surgical training has implications on future practice. The scope of VA procedures is increasing, yet the focus in vascular training remains largely in the technical aspects of surgery rather than the more comprehensive aspects of surgery applied to dialysis and renal care. To achieve special skills in vascular access surgery may require a change to traditional training with an additional focus on developing an extended portfolio of knowledge and skills. A small number of specialized courses and training facilities are developing to address these issues.

Pediatric Vascular Access Surgery

2013 ◽  
pp. 157-168
Author(s):  
Anthony L. Sparnon ◽  
Christine Russell ◽  
Brendon J. Coventry
Keyword(s):  
Vascular Access ◽  
Vascular Access Surgery ◽  
Access Surgery

scholarly journals Role of central venography prior to vascular access surgery

2021 ◽  
Vol 8 (1) ◽  
pp. 25
Author(s):  
Mustafa Razi ◽  
ChainuluV S R B Saripalli ◽  
Pradeep Burli ◽  
PremChand Gupta ◽  
Gnaneswar Atturu
Keyword(s):  
Vascular Access ◽  
Vascular Access Surgery ◽  
Access Surgery

scholarly journals Multifrecuency bioimpedance phase angle as a tool to predict maturation failure of native fistulae for hemodialysis

2021 ◽  
Vol 5 (2) ◽  
pp. 061-066
Author(s):  
Daza Lopez José Lucas ◽  
Galindo John F ◽  
Villaquiran Mónica R ◽  
Valenzuela Emilio D ◽  
Cardenas Andres ◽  
...  
Keyword(s):  
At Risk ◽  
Arteriovenous Fistula ◽  
Phase Angle ◽  
Vascular Access ◽  
Roc Curve ◽  
Statistical Significance ◽  
Bioelectrical Impedance ◽  
Hydration Status ◽  
P Value ◽  
Patients At Risk

Background and objectives: An arteriovenous fistula is considered to be an ideal vascular access for patients receiving hemodialysis, its main limitation is its high failure rate to achieve maturation and long-term functionality loss. Multiple strategies have attempted to identify patients at risk. Bioelectrical impedance has shown to be a valuable resource in the determination of the hydration status, and the measurement of the phase angle through this method has demonstrated to be a good indicator of the nutritional state and its related as a general marker of survival. The objective of this study is to analyze the role of plasma albumin and phase angle measured through bioelectrical impedance as tools useful for predicting failure of arteriovenous fistulas. Materials and methods: prospective observational study, including 104 patients with chronic kidney disease receiving hemodialysis who underwent a native arteriovenous fistula during a period of 24 months. Analyzing its clinical characteristics, laboratory and phase angle through electrical bioimpedance, both univariate and multivariate analysis was performed both with logistic regression, furthermore calculation of coordinates and ROC curve to establish a better cut-off point. Results: of the variables that were analyzed only the phase angle measurement showed statistical significance OR 2.61 (1.6 – 4.4) p - value 0.001 for predicting arteriovenous fistula failure. In female patients with a phase angle value of 3.25 had a 90% sensibility and 53% specificity for male patients a value of 3.58 showed a sensibility of 84% and a specificity of 52% with ROC curve of 0.78. Conclusion: phase angle through bioimpedance is a useful parameter, helpful in predicting failure of native arteriovenous fistula, it is also an important tool for identifying patients at risk, in early stages prior to the construction of a vascular access.

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