scholarly journals Spectrum of vascular abnormalities in color Doppler examination of upper extremities tested for suitability for AV fistula creation in patients of renal failure

2017 ◽  
Vol 4 (1) ◽  
pp. 47
Author(s):  
Seema Grover ◽  
Suprabhat Bolisetti ◽  
Shailesh Sangani ◽  
Sonali Gadhavi ◽  
Neeraja Kulkarni
Keyword(s):  
Renal Disease ◽  
Success Rate ◽  
End Stage Renal Disease ◽  
Upper Extremities ◽  
Upper Limbs ◽  
Av Fistula ◽  
Vascular Abnormalities ◽  
Doppler Study ◽  
Stage Renal Disease ◽  
End Stage

Background: Almost all patients with end stage renal disease require haemodialysis at some stage of their disease and arteriovenous fistula is the most convenient option. The purpose of this study was to analyse the prevalence of vascular abnormalities in the upper limbs of patients posted for creation of haemodialysis access. Knowledge of the variant anatomy of upper limb vessels helps in better planning of surgery, avoiding unnecessary surgery and improving the success rate of haemodialysis access creation.Methods: This study is a retrospective analysis of colour Doppler study of 150 upper extremities of end stage renal disease patients posted for AV fistula creation. The limbs were evaluated for arterial and venous anatomy rendering them fit or unfit for fistula creation.Results: We found abnormal vasculature in more than 60% of the upper limbs. Congenital arterial abnormality was found in 9 % of upper limbs and venous abnormality was found in 65 % of upper limbs. Unnecessary surgery could be avoided in approximately 74 % of patients. 10 % had correctable abnormality.Conclusions: Pre-operative ultrasound and Doppler assessment resulted in more patients being subjected to proximal fistulas and alternate suitable dialysis processes like permcath or peritoneal dialysis. Primary fistula success rate obtained by this pre-operative evaluation was close to 95 %.

scholarly journals A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease

2021 ◽  
Vol 14 (1) ◽  
pp. 44-49
Author(s):  
Md Nazmus Sabah ◽  
SM Parvez Ahmed ◽  
Md Saif Ullah Khan ◽  
Rakibul Hasan ◽  
Md Fidah Hossain ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Color Doppler ◽  
Maturation Time ◽  
Doppler Study ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Stage Renal Disease ◽  
End Stage

Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49

General Surgery in Patients with End-Stage Organ Disease

2015 ◽  
Author(s):  
Amy R. Evenson ◽  
Ramanathan M. Seshadri ◽  
Jonathan P. Fryer
Keyword(s):  
United States ◽  
Liver Disease ◽  
Renal Disease ◽  
General Surgery ◽  
End Stage Renal Disease ◽  
The United States ◽  
Av Fistula ◽  
End Stage Liver Disease ◽  
Stage Renal Disease ◽  
End Stage

The number of patients with end-stage organ disease in the United States is substantial. Patients with end-stage organ disease are susceptible to all of the surgical problems seen in general surgical practice, with the added comorbidities associated with their organ failure. Hence, understanding of the principles of perioperative patient management is important as part of a general surgery practice. The chapter contains details on general and peripheral vascular surgical procedures, including dialysis access for patients with end-stage renal disease. Details on management of abdominal hernias, cholelithiasis, and disorders of the intestine in patients with end-stage liver disease are provided. Table 1 discusses the advantages and disadvantages of arteriovenous (AV) fistulas versus AV grafts. Table 2 describes “the rule of 6’s” for mature AV fistula. Table 3 has information on potential barriers to peritoneal dialysis. Table 4 is the Child-Pugh-Turcotte classification of severity of liver disease. Table 5 discusses the factors affecting the decision to operate and timing of operation in patients with end-stage liver disease. Figure 1 shows the increasing incidence of end-stage renal disease in the United States. Figure 2 is the five-stage classification system for chronic kidney disease. Figure 3 illustrates the various options for upper extremity AV fistula. This review contains 3 figures, 5 tables, and 68 references.

scholarly journals Extracorporeal Apheresis Via AV Fistula in Multiple Myeloma Patients with End Stage Renal Disease

2016 ◽  
Vol 22 (3) ◽  
pp. S443-S444
Author(s):  
Jennifer Bourke ◽  
Tomer M. Mark ◽  
Jeffrey Silberzweig ◽  
Uvannie Enriquez ◽  
Koen van Besien ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Av Fistula ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Comparative Study of Autologous Radiocephalic and Brachiocephalic Arteriovenous Fistula in Patients with End Stage Renal Disease

2020 ◽  
Vol 18 (1) ◽  
pp. 78-81
Author(s):  
Deepak Thapa Magar ◽  
Kiran Shrestha ◽  
Dinesh Chapagain ◽  
Kumar Shrestha ◽  
Sara Thapa
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Failure Rate ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Patency Rate ◽  
Av Fistula ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
End Stage

Introduction: End-stage renal disease requires treatment with dialysis or renal transplantation. For the dialysis, autologous radiocephalic (RC) or brachiocephalic (BC) arteriovenous fistula (AVF) is the better option for vascular access for hemodialysis. Aims: The aim of this study is to find out the outcome between RC AVF and BC AVF. Methods: This is the retrospective study, conducted for the period of 24 months from September 2017 to September 2019 in the department of Cardiothoracic and Vascular Surgery of Bir Hospital, Nepal. RC and BC AVF were created for the assess of hemodialysis. Outcome and different complications were taken into consideration.  Results: The total number of patients included in this study was 400. The overall failure rate of autologous AV fistula was 12.75%. Out of these, the failure rate was more in RC AV fistula group, 34 (17%) than in BC AV fistula group, 17 (8.5%). The most common complication was bleeding in both groups having an overall rate of 39 (9.75%). The limb edema was more common in BC AV fistula group 16 (8.0%) then in RC AV fistula group 7(3.5%). The overall infection rate was 4.5%. Overall patency rate was 87.25%. Conclusion: Autologous RC AVF and BC AVF are the choices for vascular access for hemodialysis in patients with end-stage renal disease. BC AVF has a better patency rate than RC AVF but with the slight higher risk of complications.

Ultrasound Mapping of Arterial and Venous Patterns of the Upper Extremities in Patients with End-Stage Renal Disease

2012 ◽  
Vol 36 (4) ◽  
pp. 259-262
Author(s):  
Sergio X. Salles-Cunha ◽  
Diana L. Neuhardt ◽  
Barbara Pohle-Schulze ◽  
Marresa Neuhardt ◽  
Nicole Straight
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Upper Extremities ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Endovascular Balloon Treatment of a Failing Arteriovenous Fistula. A Case Report.

2021 ◽  
Vol 4 (4) ◽  
pp. 01-03
Author(s):  
Emmanuel Edafe
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Normal Serum ◽  
Tips And Tricks ◽  
Av Fistula ◽  
Essentially Normal ◽  
Life Saving ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

BACKGROUND: Arterio-venous (AV) fistula is created for patients requiring renal replacement therapy (hemodialysis and hemofiltration). A failing A-V fistula requires urgent treatment to keep it patent. Understanding the simple tips and tricks will contribute to the quality of life for the patient with end-stage renal disease and reducing radiation dose to the operator. CASE SUMMARY: A 77 year old male with end-stage renal disease, hypertension and coronary artery disease. He has been on regular haemodialysis after A-V fistula (left forearm) was constructed in 2013. He presented with 2 weeks history of A-V fistula occlusion. Examination was essentially normal. Serum sodium=136mmol/l, potassium=5.5mmol/l urea=100mg/l, creatinine=3.5mg/dl. The Doppler scan showed 50 % stenosis just proximal to the anastomosis with calcification. Percutenous arteriography and venography was done with non-compliance balloon (3x12mm) up to 24 atm . The post procedure venography showed restoration of flow across the fistula. CONCLUSION: Endovascular treatment of a failing A-V fistula can be life saving. The simple tips and tricks of using the groin route, reducing the concentration of contrast and maneuver devices may contribute to safety and reduce radiation to the operator.

scholarly journals Hemodialysis AV Fistula: What a Radiologist Should Know?

2021 ◽  
Author(s):  
Vaidehi A. Patel
Keyword(s):  
Surgical Technique ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Color Doppler ◽  
Av Fistula ◽  
Doppler Study ◽  
Operative Evaluation ◽  
Vascular Mapping ◽  
Stage Renal Disease ◽  
End Stage

Hemodialysis works as a lifeline for end stage renal disease patients. Creation and maintenance of vascular access for dialysis is the mammoth task. Due to increased references related to vascular access; number of complications are faced in pre as well as post operative period of vascular access creation. Ultrasound and color Doppler study play a major role in imaging throughout this period. Pre operative vascular mapping is very crucial to help surgeon to determine the proper site and surgical technique for vascular access creation. Early and delayed post operative complications can also be diagnosed with ultrasound and color Doppler study. Here we have tried to cover all the important points which a radiologist should consider during pre operative vascular mapping and post operative evaluation of vascular access as well as any associated complications.

scholarly journals Hemodynamic and Biologic Determinates of Arteriovenous Fistula Outcomes in Renal Failure Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mary Hammes
Keyword(s):  
Renal Failure ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Success Rate ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Neointimal Hyperplasia ◽  
Venous Stenosis ◽  
Stage Renal Disease ◽  
End Stage

The outcome of patients with end-stage renal disease on hemodialysis depends on a functioning vascular access. Although a variety of access options are available, the arteriovenous fistula remains the best vascular access. Unfortunately the success rate of mature fistula use remains poor. The creation of an arteriovenous fistula is followed by altered hemodynamic and biological changes that may result in neointimal hyperplasia and eventual venous stenosis. This review provides an overview of these changes and the needed research to provide a long lasting vascular access and hence improve outcomes for patients with end-stage renal disease.

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