Simultaneous placement of leadless pacemaker and dialysis catheter in patient with exhausted vasculature

2019 ◽  
pp. 112972981989408
Author(s):  
Dawid Bednarczyk ◽  
Wiktor Kuliczkowski ◽  
Krzysztof Letachowicz ◽  
Marcin Dzidowski ◽  
Tomasz Witkowski ◽  
...  
Keyword(s):  
Vascular Access ◽  
Electronic Device ◽  
Cardiac Pacemaker ◽  
Cardiac Pacing ◽  
Venous Access ◽  
Cardiac Implantable Electronic Device ◽  
Leadless Pacemaker ◽  
Access Problem ◽  
Arteriovenous Access

The problem with limited venous access may occur in patients receiving long-term hemodialysis treatment with no possibility of arteriovenous access or in patients with cardiac implantable electronic device–related infection leading to the removal of cardiac implantable electronic device. We present a case report where both situations occur simultaneously. Using recent development in cardiac pacing—leadless cardiac pacemaker—we manage to overcome the vascular access problem. The described case emphasizes the necessity of multispecialty collaboration and gains of new pacing technology in patients who need placement of vascular access for hemodialysis and cardiac implantable electronic device where vascular access is scarce.

Cardiac implantable electronic device and vascular access: Strategies to overcome problems

2018 ◽  
Vol 19 (6) ◽  
pp. 521-527 ◽  
Author(s):  
Mariusz Kusztal ◽  
Krzysztof Nowak
Keyword(s):  
Kidney Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Vascular Access ◽  
Electronic Device ◽  
Cardiac Resynchronization ◽  
Rapid Progression ◽  
Central Vein ◽  
Cardiac Implantable Electronic Device ◽  
Cardioverter Defibrillator ◽  
Leadless Pacemaker

For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter. Fortunately, cardiac electrotherapy is moving toward miniaturization and less transvenous wires. Whenever feasible, one should avoid transvenous leads and choose alternative options such as subcutaneous implantable cardioverter defibrillator, epicardial leads, and leadless pacemaker. Based on recent reports on the leadless pacemaker/implantable cardioverter defibrillator effectiveness, in patients with rapid progression of chronic kidney disease (high risk of renal failure) or glomerular filtration rate <20 mL/min/1.73 m2, this option should be considered by the implanting cardiologist for future access protection.

scholarly journals Predictors of Long-Term Infections After Cardiac Implantable Electronic Device Surgery　― Utility of Novel PADIT and PACE DRAP Scores ―

2020 ◽  
Vol 84 (10) ◽  
pp. 1754-1763
Author(s):  
Sylwia Sławek-Szmyt ◽  
Aleksander Araszkiewicz ◽  
Marek Grygier ◽  
Krzysztof Szmyt ◽  
Lidia Chmielewska-Michalak ◽  
...  
Keyword(s):  
Electronic Device ◽  
Cardiac Implantable Electronic Device

Advanced vascular access

2019 ◽  
pp. 177-190
Author(s):  
Richard Craig
Keyword(s):  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Short Term ◽  
Central Lines ◽  
Venous Access Devices

In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.

scholarly journals End-of-life Management of Leadless Cardiac Pacemaker Therapy

2017 ◽  
Vol 6 (3) ◽  
pp. 129 ◽  
Author(s):  
Niek EG Beurskens ◽  
Fleur VY Tjong ◽  
Reinoud E Knops ◽  
◽  
◽  
...  
Keyword(s):  
End Of Life ◽  
Cardiac Pacemaker ◽  
Life Strategy ◽  
Pacemaker Therapy ◽  
New Device ◽  
Novel Technique ◽  
Leadless Pacemaker ◽  
Novel Technology ◽  
Potential Risks

The clinically available leadless pacemakers for patients with a single-chamber pacing indication have shown to be safe and effective. However, the optimal end-of-life strategy of this novel technique is undefined. Suggested strategies comprise of (a) placing an additional leadless device adjacent to the leadless pacemaker, or (b) retrieving the non-functioning leadless pacemaker and subsequently implanting a new device. Although initial studies demonstrate promising results, early experience of acute and mid-term retrieval feasibility and safety remains mixed. We suggest that the approach of leadless pacemaker retrieval is more appealing to limit the amount of non-functioning intracardiac hardware. In addition, potential risks for device–device interference, and unknown long-term complications associated with multiple intracardiac devices are prevented. The potential inability to retrieve chronically implanted leadless pacemakers limits the application of this novel technology. Therefore, long-term prospective analysis is required to define the most optimal end-of-life strategy.

scholarly journals Basilic Vein Transposition Used as a Tertiary Vascular Access for Hemodialysis: 15 Years of Experience

2016 ◽  
Vol 8 ◽  
pp. OJCS.S34837 ◽  
Author(s):  
Róbert Novotný ◽  
Marcela Slavíková ◽  
Jaroslav Hlubocký ◽  
Petr Mitáš ◽  
Jan Hrubý ◽  
...  
Keyword(s):  
Vascular Access ◽  
Infectious Complications ◽  
Primary Patency ◽  
Secondary Patency ◽  
Basilic Vein ◽  
Time Period ◽  
Patient Database ◽  
Arteriovenous Access

Introduction The quality of the life in patients requiring long term hemodialysis is directly proportional to the long-term patency of their vascular access. Basilic vein transposition for vascular access (BAVA) represents a suitable option for creating a tertiary native vascular access for hemodialysis on the upper extremities for patients requiring long term hemodialysis. The purpose of the study is to compare BAVAs with arteriovenous grafts (AVG). Method Data collection was based on selecting all of the patients with BAVA created in the time period in between January 1996 and August 2011. A questionnaire was created and sent to the selected hemodialysis centers. The resulting set of data was statistically analyzed and evaluated. Results In the time period between 1 January 1996 and August 2011, arteriovenous access for hemodialysis was created in 6754 patients (7203 procedures in total). Out of these patients, 175 BAVAs were created. Our patient database of those undergoing the BAVA procedure consisted of 98 females (56%) and 77 males (44%) with an average age of 64.5 years. The prevalence of diabetes mellitus was 60% (105 patients). Primary patency after 12 months was 68.8%, 24 months 59.7%, 36 months 53.8, 48 months 53.8%, and 60 months 50%. Primary assisted patency after 12 months was 89.9%, 24 months 84.6%, 36 months 77.8%, 48 months 77.9%, 60 months 70.8%. Secondary patency after 12 months was 89.4%, 24 months 86.9%, 36 months 81%, 48 months 78.9%, 60 months 75.7%. Twenty-nine BAVAs (16.5%) were obliterated. Conclusion Patients benefit from this type of procedure due to the longer patency of a native arteriovenous access, as well as a lower incidence of infectious complications.

A triple tunnel from the mid-calf to the femoral vein in patient with severe dementia

2021 ◽  
pp. 112972982110268
Author(s):  
Matthew Ostroff ◽  
Nagwa Hafez ◽  
Toni Ann Weite
Keyword(s):  
Vascular Access ◽  
Femoral Vein ◽  
Venous Access ◽  
Exit Site ◽  
Severe Dementia ◽  
Femoral Catheter ◽  
Scapular Region ◽  
The Ideal

Achieving the ideal exit site is the new philosophy for complicated vascular access patients. Recent publications have described multiple venous access solutions such as tunneling to the scapular region, the chest to the arm, and from the femoral vein to the abdominal and patellar region. In the patients afflicted with delirium, dementia, or confusion even these sites may not be sufficient. The following case study illustrates a triple tunneled femoral catheter on a non-cooperative patient with inoperable endocarditis to be discharged and treated with long term antibiotics.

scholarly journals INFLUENCE OF LONG-TERM CYTOTOXIC CHEMOTHERAPY ON THE CONDITION OF PERIPHERAL VENOUS CHANNEL

2017 ◽  
Vol 3 ◽  
pp. 49-55
Author(s):  
Tetiana Tkachuk
Keyword(s):  
Cancer Patients ◽  
Vascular Access ◽  
Venous Access ◽  
Term Treatment ◽  
Cytotoxic Chemotherapy ◽  
Cytotoxic Therapy ◽  
Qualitative And Quantitative ◽  
Long Term Treatment ◽  
Term Administration

The necessity of long-term venous access in cancer patients appears at frequent and long-term courses of cytotoxic therapy. Peripheral veins of forearms are most often used for these aims. The conditions of peripheral venous channel in 32 cancer patients, who underwent the long-term treatment with antitumor preparations were analyzed in the article on own investigatory material. The methods of dopplerography, morphological and immunohystochemical studies were used. The qualitative and quantitative dopplerographic changes in forearm veins in different terms after chemotherapy start were revealed in most patients. The conclusion was made about unsuitability of forearm peripheral veins for the long term administration of cytostatics and the necessity to create the alternative vascular access that would correspond to the criteria of safety, reliability and long-term exploitation.

Vascular Access Devices: A Patient's Perspective

2005 ◽  
Vol 10 (2) ◽  
pp. 81-84
Author(s):  
Talulah Ruger
Keyword(s):  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Chronic Illnesses ◽  
Home Setting ◽  
Vascular Access Devices ◽  
Patient’S Perspective ◽  
Parental Nutrition

Abstract Various vascular access devices are available and widely used in the hospital and home setting for the treatment of patients with acute and chronic illnesses. Many cancer patients, in particular, require Short- or long-term central venous access for the intravenous administration of chemotherapy, immunotherapy, blood products, antibiotics, total parental nutrition, and other medications. This author, a breast cancer survivor and a nurse, examines the benefits and drawbacks of venous access devices, the satisfaction and dissatisfaction with their use, and the effects these devices have on treatment and quality of life from a patient's perspective.

The case for using implanted ports

2019 ◽  
Vol 28 (Sup14a) ◽  
pp. S3-S10 ◽  
Author(s):  
Jane Hodson
Keyword(s):  
Bloodstream Infection ◽  
Vascular Access ◽  
Central Venous Access ◽  
Venous Access ◽  
Low Risk ◽  
Central Venous ◽  
Different Types ◽  
Venous Access Devices ◽  
Catheter Related Bloodstream Infection

Uses of central venous access devices (CVADs) include the administration of vital fluids and medications. Implanted ports are a type of CVAD that is used when long-term vascular access is required. The device is discreet and associated with a low risk of catheter-related bloodstream infection. This article describes the different types and components of ports and how to select them. It explains how to insert ports, and provides guidance on accessing and de-accessing them

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