scholarly journals Routes to Improve Arteriovenous Fistula Formation for Haemodialysis

2021 ◽  
Vol 11 (3) ◽  
pp. 203-208
Author(s):  
M. V. Timerbulatov ◽  
D. R. Ibragimov
Keyword(s):  
Vascular Surgery ◽  
Arteriovenous Fistula ◽  
Median Survival Time ◽  
Balloon Dilation ◽  
Fistula Formation ◽  
Capacity Assessment ◽  
Surgical Interventions ◽  
Main Technique ◽  
Time To Relapse ◽  
Mean Time

Background. Contemporary methods to create primary arteriovenous fistula (AVF) for permanent vascular access (PVA) in haemodialysis continue to improve. The modified Brescia-Cimino operation is considered the main technique of forming native AVF. Various early PVA complications occur in 6–40 % patients entailing repeated surgical interventions.Materials and methods. The study was conducted at the vascular surgery unit of City Clinical Hospital No. 21 of Ufa. All patients had surgery for distal AVF formation in forearm. Native forearm AVF creation was aided by the hydraulic balloon dilation technique prior to forming anastomosis.Results. The PVA survival was 75.0 (n = 30), the median survival time corresponding to estimated time-to-rehospitalisation in at least 50 % patients (n = 30) was 4.0 ± 0.89 (95 % CI: 2.25–5.75) months. Mean time-to-relapse was 6.05 ± 1.15 (95 % CI: 3.8–8.3) months.Discussion. The results obtained suggest the accessory hydraulic balloon dilation method useful prior to forming anastomosis to provide for the vein mechanical expansion, outflow capacity assessment and prevent venous torsion at preparation steps. Preparing a certain vein length (10 cm) with ligation of putative tributaries is also of importance.Conclusion. The accessory technique of hydraulic balloon dilation of recipient vein in primary native AVF creation allows an intraoperative estimation of the vein state to exclude torsion and perform its mechanical dilation prior to forming anastomosis, which reduces the risk of postoperative thromboses.

scholarly journals Assessment of necessity of neuronavigation in localization of calvarial extra-axial lesions in the setting of limited resources

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussein Soffar ◽  
Mohamed F. Alsawy
Keyword(s):  
Conventional Method ◽  
Linear Measurement ◽  
Limited Resources ◽  
Linear Measurements ◽  
Surgical Interventions ◽  
Localization Method ◽  
Mean Error ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Abstract Background Neuronavigation is a very beneficial tool in modern neurosurgical practice. However, the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in localizing the calvarial extra-axial lesions and to what extent it is safe to operate without it. Methods We studied twenty patients with calvarial extra-axial lesions who underwent surgical interventions. All lesions were preoperatively located with both neuronavigation and the usual linear measurements. Both methods were compared regarding the time consumed to localize the tumor and the accuracy of each method to anticipate the actual center of the tumor. Results The mean error of distance between the planned center of the tumor and the actual was 6.50 ± 1.762 mm in conventional method, whereas the error was 3.85 ± 1.309 mm in IGS method. Much more time was consumed during the neuronavigation method including booting, registration, and positioning. A statistically significant difference was found between the mean time passed in the conventional method and IGS method (2.05 ± 0.826, 24.90 ± 1.334, respectively), P-value < 0.001. Conclusion In the setting of limited resources, the linear measurement localization method seems to have an accepted accuracy in the localization of calvarial extra-axial lesions and it saves more time than neuronavigation method.

Percutaneous Management of Benign Biliary Strictures

2021 ◽  
Vol 38 (03) ◽  
pp. 291-299
Author(s):  
Adam Fang ◽  
Il Kyoon Kim ◽  
Ifechi Ukeh ◽  
Vahid Etezadi ◽  
Hyun S. Kim
Keyword(s):  
Treatment Options ◽  
Balloon Dilation ◽  
Percutaneous Transhepatic Cholangiography ◽  
Team Approach ◽  
Biliary Strictures ◽  
Surgical Interventions ◽  
Benign Biliary Strictures ◽  
Elevated Liver Enzymes ◽  
Biodegradable Stents ◽  
Asymptomatic Disease

AbstractBenign biliary strictures are often due to a variety of etiologies, most of which are iatrogenic. Clinical presentation can vary from asymptomatic disease with elevated liver enzymes to obstructive jaundice and recurrent cholangitis. Diagnostic imaging methods, such as ultrasound, multidetector computed tomography, and magnetic resonance imaging (cholangiopancreatography), are used to identify stricture location, extent, and possible source of biliary obstruction. The management of benign biliary strictures requires a multidisciplinary team approach and include endoscopic, percutaneous, and surgical interventions. Percutaneous biliary interventions provide an alternative diagnostic and therapeutic approach, especially in patients who are not amenable to endoscopic evaluation. This review provides an overview of benign biliary strictures and percutaneous management by interventional radiologists. Diagnostic evaluation with percutaneous transhepatic cholangiography and treatment options, including biliary drainage, balloon dilation, retrievable/biodegradable stents, and other innovative minimally invasive options, are discussed.

Rozycki-Feliciano Lecture Rudolph Matas, the Father of Vascular Surgery

2022 ◽  
pp. 000313482110697
Author(s):  
Richard J. Field ◽  
Don K. Nakayama
Keyword(s):  
Vascular Surgery ◽  
Arteriovenous Fistula ◽  
New Orleans ◽  
Artery Aneurysm ◽  
Peripheral Artery ◽  
Medical Degree ◽  
History Of Vascular Surgery ◽  
Continuous Service ◽  
American College Of Surgeons ◽  
History Of

Rudolph Matas (1860-1957) was one of the foremost figures in the history of vascular surgery. He is considered the father of vascular surgery for his operations for arteriovenous fistula and peripheral artery aneurysm, all devised before the isolation of heparin and the wide adoption of techniques for vascular anastomosis. A medical and surgical prodigy, Matas received his medical degree from Tulane University at age 19 (1880) and was named its chair of surgery at 35 (1895), a position he would hold until 1927. A contemporary and friend of Halsted, Matas throughout his career he was known as a leader in the field, holding the presidencies of the American College of Surgeons (1925-1926) and the American Surgical Association (1909). He maintained loyal relationships to those who trained in surgery with him at Touro Hospital in New Orleans, including the author’s grandfather, the first Richard J. Field. Matas was an honored guest at the dedication of the Centreville Clinic in 1928, the facility where three generations of Field surgeons have provided continuous service to its rural Mississippi community for nearly a century.

Abstract 461: A Novel Model of Spontaneous Arteriovenous Fistula Formation

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Yukinobu Ito ◽  
Makoto Yoshida ◽  
Hirotake Masuda ◽  
Hiroshi Nanjo ◽  
Akiteru Goto
Keyword(s):  
Arteriovenous Fistula ◽  
Network Formation ◽  
Rabbit Model ◽  
Angiogenic Factors ◽  
Fistula Formation ◽  
Arterial Graft ◽  
Fish Analysis ◽  
Sphincter Muscle ◽  
Arterial Blood

Aims: Most In vivo angiogenesis studies have been performed by setting an ischemic condition, or by administrating angiogenic factors such as vascular endothelial growth factor. Unexpectedly, we discovered to spontaneously create new blood vessels by just suturing an arterial graft patch in the jugular vein, using a rabbit model. In general, arteriovenous malformations consist of tangles of arteries and veins that are often connected by a fistula. However, the causes and mechanisms of these clinical entities are not fully understood. The purpose of this study is to show the methods used to produce the model, and then to report the chronological processes involved in the development of this neovasculature and the change of endogenous angiogenic factors. Methods and Results: We performed to suture an arterial graft patch into the rabbit vein. Within a month after the surgery, dense (nidus-like) neovasculature was formed around the patch. Angiography and pulse-oximeter analyses demonstrated that the blood, which flew into the new vessels, was arterial blood. It means that arteriovenous shunt has been formed.. Pathological evaluation revealed multiple branching vessels sprouting out from the patch suture site, and numerous dilated vessels devoid of sphincter muscle in the surrounding connective tissue. We determined, by FISH analysis, that these branches had originated from the graft itself. The endogenous angiogenic factors, such as VEGF, have soared immediately after the surgery. Conclusion: This is the first in vivo model of spontaneous arteriovenous fistula formation via the creation of neovasculature. These findings exemplify the difference between the arterial and venous intima, and we believe that this difference could be key to understanding human vascular anomaly diseases and the basic principles of vascular network formation, angiogenesis and/or vasculogenesis.

Surgery for disorders of erectile function, ejaculation, and seminal vesicles

2020 ◽  
pp. 631-650
Author(s):  
Suzanne Biers ◽  
Noel Armenakas ◽  
Alastair Lamb ◽  
Stephen Mark ◽  
John Reynard ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Surgical Treatment ◽  
Vascular Surgery ◽  
Erectile Function ◽  
Penile Prosthesis ◽  
Seminal Vesicles ◽  
Peyronie’S Disease ◽  
Surgical Interventions ◽  
Peyronie's Disease

This chapter begins by covering the physiology of erections and ejaculation. It provides ways of evaluating erectile dysfunction and then surgical interventions, including vascular surgery and penile prosthesis. Finally, surgical treatment for Peyronie’s disease is covered.

scholarly journals Retrospective Analysis of Patients Referred for Arteriovenous Fistula Formation

2018 ◽  
Vol 56 (5) ◽  
pp. e24
Author(s):  
Andrew S. Kucey ◽  
Doireann Joyce ◽  
Teresa O’Neill ◽  
Greg Fulton ◽  
Brian J. Manning
Keyword(s):  
Arteriovenous Fistula ◽  
Retrospective Analysis ◽  
Fistula Formation

scholarly journals A rare case of arteriovenous fistula formation in a patient with inferior vena cava thrombosis, successfully managed with endovascular recanalisation

2019 ◽  
Vol 5 (4) ◽  
pp. 20190007
Author(s):  
Vanya Joshi ◽  
Frances Sheehan ◽  
Alexander Chapman
Keyword(s):  
Inferior Vena Cava ◽  
Arteriovenous Fistula ◽  
Animal Studies ◽  
Inferior Vena ◽  
Vena Cava ◽  
Lower Extremities ◽  
Venous Hypertension ◽  
Fistula Formation ◽  
Ivc Thrombosis ◽  
Ivc Filters

Inferior vena cava (IVC) filters are recommended for patients with proximal deep vein thrombosis (DVT) who are not eligible for anticoagulation. Long-dwelling filters are well-known to be associated with the development of IVC thrombosis. Chronic caval occlusion can lead to a severe post-thrombotic syndrome (PTS), with manifestations of chronic venous insufficiency in the lower extremities. Animal studies have shown that post-thrombotic inflammation can trigger the development of an arteriovenous fistula (AVF), however, there is limited evidence for this phenomenon in patients with PTS. We describe the case of a spontaneous AVF in a patient with long-standing IVC thrombosis. It was postulated that the AVF could be compounding the venous hypertension and severe swelling of his lower extremities. The case additionally demonstrates the successful results of endovascular recanalisation for an occluded filter in the presence of an AVF.

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