scholarly journals Dril Procedure: Treatment for Vascular Access Induced Hand Ischemia. Case Report

2021 ◽  
Vol 26 (1) ◽  
pp. 25-27
Author(s):  
Claudiu Helgiu
Keyword(s):  
Case Report ◽  
Diabetic Patient ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Chronic Hemodialysis ◽  
Diabetic Patients ◽  
Basilic Vein ◽  
Central Venous ◽  
Hand Ischemia

Abstract Native vascular access (AVF arteriovenous fistula) for chronic hemodialysis (CH) performed proximally to the diabetic patient, between the brachial artery and the basilic vein or cephalic vein, determines the risk of distal (hand) ischemia. The correction of the ischemia can be done differently depending on its severity, starting from the vasodilator medication, reaching the cancellation of the vascular access with the accomplishment of the chronic hemodialysis on the central venous catheter. DRIL procedure (Distal Revascularization and Interval Ligation) corrects distal ischemia while maintaining functional vascular access, an important aspect in diabetic patients in whom vascular capital is deficient. We further describe a case of a diabetic patient with right L-T brachiocephalic arteriovenous fistula, with important ischemic phenomena in which the DRIL procedure resolved the ischemia, the patient using vascular access as usual, the second postoperative day.

Vascular access for chronic hemodialysis in children: arteriovenous fistula or central venous catheter?

2014 ◽  
Vol 29 (12) ◽  
pp. 2395-2401 ◽  
Author(s):  
Aicha Merouani ◽  
Michel Lallier ◽  
Julie Paquet ◽  
Johanne Gagnon ◽  
Anne Laure Lapeyraque
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Chronic Hemodialysis ◽  
Central Venous

scholarly journals Vascular access for hemodialysis: Current practice in Vietnam

2018 ◽  
Vol 20 (1_suppl) ◽  
pp. 20-23 ◽  
Author(s):  
Long Duc Dinh ◽  
Dung Huu Nguyen
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Transluminal Angioplasty ◽  
Central Venous Catheters ◽  
Chronic Hemodialysis ◽  
Maintenance Hemodialysis ◽  
Central Venous ◽  
Advanced Country

A well-functioning vascular access is a mainstay to perform an efficient hemodialysis procedure, which directly affects the quality of life in hemodialysis patients. We use three main types of access: native arteriovenous fistula, arteriovenous graft, and central venous catheter. Arteriovenous fistula remains the first and best choice for chronic hemodialysis. It is the best access for longevity, the lowest related complications, and for this reason, arteriovenous fistula use is strongly recommended by guidelines from different countries, including Vietnam. In practice, well-functioning arteriovenous fistula creation is not always simple. In this case, arteriovenous fistula creation with vein transposition or translocation is certainly useful. When native vein options have been exhausted, prosthetic can be used as the second option of maintenance hemodialysis access alternatives. Central venous catheters are very common and have become an important adjunct in maintaining patients on hemodialysis. In Bach Mai hospital, we certainly create about 1000 new arteriovenous fistulas every year (among these, about 84.98% new hemodialysis patients start hemodialysis without permanent accesses and depend on temporary central venous catheters) and successfully matured arteriovenous fistula rate is 92.6%. Among hemodialysis population in Bach Mai, 2.29% have arteriovenous grafts and 2.81% of patients still depend on cuffed tunneled catheters. The preferable locations for catheter insertions are the internal jugular and femoral veins. Proper vascular access maintenance requires integration of different professionals to create a vascular access team. Percutaneous transluminal angioplasty is not available. In our circumstance, we have achieved some advantages for hemodialysis patients but still a big gap to an advanced country.

Superficialization of Basilic Vein: Last Chance for a Native Arteriovenous Fistula in Hemodialysis Patients

2003 ◽  
Vol 4 (1) ◽  
pp. 21-24 ◽  
Author(s):  
M. Onaran ◽  
D. Erer ◽  
I. Şen ◽  
E.E. Elnur ◽  
E. Iriz ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachial Artery ◽  
Subcutaneous Tissue ◽  
Vascular Grafts ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Basilic Vein ◽  
Number Of Patients

Background Although the best type of vascular access for chronic hemodialysis patients is a native arteriovenous fistula, in an increasing number of patients all the superficial veins have been used and only the placement of vascular grafts or permanent catheters is left. Superficialization of the basilic vein is a possible alternative. Materials and Methods In 49 chronic hemodialysis patients who had no possibilities to have a native arteriovenous fistula created, we performed a basilic vein- brachial artery fistula in the arm. During the same operation the basilic vein was then superficialized for easier access for hemodialysis. Results Mean follow-up was 22.36±15.56 months. Forty-eight patients are still undergoing hemodialysis with their superficialized basilic vein native A-V fistula without any complications. Only one fistula was thrombosed just after the procedure because of poor vessel quality. Conclusion For hemodialysis patients who have no suitable superficial veins at the wrist or elbow, performing a basilic vein - brachial artery fistula and superficializing the vein to the subcutaneous tissue is an acceptable choice before deciding to use more complicated procedures like vascular grafts.

Aneurysm of Arteriovenous Fistula in Uremic Patients: Is Endograft a Viable Therapeutic Approach?

2002 ◽  
Vol 3 (2) ◽  
pp. 85-88 ◽  
Author(s):  
P.M. Allaria ◽  
E. Costantini ◽  
A. Lucatello ◽  
E. Gandini ◽  
F. Caligara ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Venous Catheter ◽  
Good Alternative ◽  
Central Venous ◽  
Arteriovenous Fistulas ◽  
Risk Of Rupture ◽  
Arterial Aneurysms ◽  
Percutaneous Insertion

One of the complications of arteriovenous fistulas in chronic hemodialyzed patients is the onset of an aneurysm which can be at risk of rupture. Traditional surgical repair is not always feasible and may not be successful in these cases, leading therefore to the loss of a functioning vascular access and requiring in any case the temporary use of a central venous catheter to allow regular hemodialysis sessions. We applied to this kind of aneurysm the same experience developed in the management of major arterial aneurysms and we considered endografting repair a good alternative in this case. In this paper we present the successful treatment of an arteriovenous fistula aneurysm using that technique. A distal radio-cephalic arteriovenous fistula in one of our patients presented an aneurysm with high risk of rupture. The endografting repair with percutaneous insertion of a Wallgraft™ endoprosthesis was well tolerated and the vascular access could be used the day after, without the need for a central venous catheter insertion.

American Association of Kidney Patients survey of patient preferences for hemodialysis vascular access

2019 ◽  
Vol 21 (2) ◽  
pp. 230-236
Author(s):  
Saravanan Balamuthusamy ◽  
Larry E Miller ◽  
Diana Clynes ◽  
Erin Kahle ◽  
Richard A Knight ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Renal Disease ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
American Association ◽  
Venous Catheter ◽  
Central Venous ◽  
Stage Renal Disease ◽  
End Stage

Objectives: To determine the vascular access modalities used for hemodialysis, the reasons for choosing them, and determinants of satisfaction with vascular access among patients with end-stage renal disease. Methods: The American Association of Kidney Patients Center for Patient Research and Education used the American Association of Kidney Patients patient engagement database to identify eligible adult hemodialysis patients. Participants completed an online survey consisting of 34 demographic, medical history, and hemodialysis history questions to determine which vascular access modalities were preferred and the reasons for these preferences. Results: Among 150 respondents (mean age 54 years, 53% females), hemodialysis was most frequently initiated with central venous catheter (64%) while the most common currently used vascular access was arteriovenous fistula (66%). Most (86%) patients previously received an arteriovenous fistula, among whom 77% currently used the arteriovenous fistula for vascular access. Older patients and males were more likely to initiate hemodialysis with an arteriovenous fistula. The factors most frequently reported as important in influencing the selection of vascular access modality included infection risk (87%), physician recommendation (84%), vascular access durability (78%), risk of complications involving surgery (76%), and impact on daily activities (73%); these factors were influenced by patient age, sex, and race. Satisfaction with current vascular access was 90% with arteriovenous fistula, 79% with arteriovenous graft, and 67% with central venous catheter. Conclusion: Most end-stage renal disease patients continue to initiate hemodialysis with central venous catheter despite being associated with the lowest satisfaction rates. While arteriovenous fistula was associated with the highest satisfaction rate, there are significant barriers to adoption that vary based on patient demographics and perception of procedure invasiveness.

scholarly journals Predictors of Arteriovenous Fistula Failure: A Post Hoc Analysis of the FAVOURED Study

Kidney360 ◽  
2020 ◽  
Vol 1 (11) ◽  
pp. 1259-1269
Author(s):  
Yong Pey See ◽  
Yeoungjee Cho ◽  
Elaine M. Pascoe ◽  
Alan Cass ◽  
Ashley Irish ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Controlled Trial ◽  
Laboratory Data ◽  
Venous Catheter ◽  
Central Venous ◽  
Factors Associated ◽  
Female Sex ◽  
Post Hoc

BackgroundAn autologous arteriovenous fistula (AVF) is the preferred hemodialysis vascular access, but successful creation is hampered by high rates of AVF failure. This study aimed to evaluate patient and surgical factors associated with AVF failure to improve vascular access selection and outcomes.MethodsThis is a post hoc analysis of all participants of FAVOURED, a multicenter, double-blind, multinational, randomized, placebo-controlled trial evaluating the effect of fish oil and/or aspirin in preventing AVF failure in patients receiving hemodialysis. The primary outcome of AVF failure was a composite of fistula thrombosis and/or abandonment and/or cannulation failure at 12 months post-AVF creation, and secondary outcomes included individual outcome components. Patient data (demographics, comorbidities, medications, and laboratory data) and surgical factors (surgical expertise, anesthetic, intraoperative heparin use) were examined using multivariable logistic regression analyses to evaluate associations with AVF failure.ResultsOf 536 participants, 253 patients (47%) experienced AVF failure during the study period. The mean age was 55±14.4 years, 64% were male, 45% were diabetic, and 4% had peripheral vascular disease. Factors associated with AVF failure included female sex (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.20 to 2.68), lower diastolic BP (OR for higher DBP, 0.85; 95% CI, 0.74 to 0.99), presence of central venous catheter (OR, 1.49; 95% CI, 1.02 to 2.20; P=0.04), and aspirin requirement (OR, 1.60; 95% CI, 1.00 to 2.56).ConclusionsFemale sex, requirement for aspirin therapy, requiring hemodialysis via a central venous catheter, and lower diastolic BP were factors associated with higher odds of AVF failure. These associations have potential implications for vascular access planning and warrant further studies.

Superficialization of Basilic Vein: Last Chance for a Native Arteriovenous Fistula in Hemodialysis Patients

2003 ◽  
Vol 4 (1) ◽  
pp. 21-24
Author(s):  
M. Onaran ◽  
D. Erer ◽  
I. Şen ◽  
E.E. Elnur ◽  
E. Iriz ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachial Artery ◽  
Subcutaneous Tissue ◽  
Vascular Grafts ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Basilic Vein ◽  
Number Of Patients

Background Although the best type of vascular access for chronic hemodialysis patients is a native arteriovenous fistula, in an increasing number of patients all the superficial veins have been used and only the placement of vascular grafts or permanent catheters is left. Superficialization of the basilic vein is a possible alternative. Materials and Methods In 49 chronic hemodialysis patients who had no possibilities to have a native arteriovenous fistula created, we performed a basilic vein- brachial artery fistula in the arm. During the same operation the basilic vein was then superficialized for easier access for hemodialysis. Results Mean follow-up was 22.36±15.56 months. Forty-eight patients are still undergoing hemodialysis with their superficialized basilic vein native A-V fistula without any complications. Only one fistula was thrombosed just after the procedure because of poor vessel quality. Conclusion For hemodialysis patients who have no suitable superficial veins at the wrist or elbow, performing a basilic vein - brachial artery fistula and superficializing the vein to the subcutaneous tissue is an acceptable choice before deciding to use more complicated procedures like vascular grafts.

scholarly journals Multicenter Investigation of the Initial Hemodialysis Vascular Access and Its Related Factors in Hangzhou of China

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qisu Ying ◽  
Yong Mao ◽  
Xiangcheng Xie ◽  
Ping Wu ◽  
Jilin Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
End Stage Renal Disease ◽  
Venous Catheter ◽  
Chronic Glomerulonephritis ◽  
Central Venous ◽  
Hemodialysis Vascular Access ◽  
Stage Renal Disease ◽  
End Stage

Objective. To investigate the initial hemodialysis vascular access in Hangzhou and provide evidence for improving the use of autologous arteriovenous fistula by identifying factors associated with the choice of initial vascular access. Methods. We retrospectively studied the initial hemodialysis vascular access of 257 patients in five hemodialysis units in Hangzhou of China during a 21-month period (January 2018 to September 2019). A logistic regression was used to identify the risk factors of failing to use an arteriovenous fistula at the initiation of hemodialysis. Results. (1) 257 participants with mean age 67.65 ± 13.43 years old were reviewed, including 165 males (64.2%) and 92 females (35.8%). The etiologies of end-stage renal disease included diabetic nephropathy (37.35%), chronic glomerulonephritis (31.13%), hypertensive nephropathy (14.01%), and other diseases (17.51%). Only 51 patients (19.84%) received arteriovenous fistula, whereas the remaining 206 patients (80.16%) initiated dialysis with a central venous catheter. (2) Logistic regression analysis revealed that the independent risk factors for central venous catheter at the initial hemodialysis were age >70 years old ( OR = 4.827 , p < 0.01 versus ≤70 years old), chronic glomerulonephritis as the primary etiology ( OR = 2.565 , p < 0.05 versus nonchronic glomerulonephritis) and eGFR <8.5 mL/min/1.73m2 ( OR = 2.283 , p < 0.05 versus eGFR ≥8.5 mL/min/1.73m2). Conclusion. The proportion of patients using arteriovenous fistula as the initial hemodialysis vascular access in Hangzhou was still low. The choice of vascular access for the first hemodialysis was related to age, eGFR, and the primary etiology of end-stage renal disease. Increasing the proportion of planned vascular access and arteriovenous fistula at the initiation of hemodialysis is still our current goal.

A Stuck Hemodialysis Central venous Catheter

2008 ◽  
Vol 9 (4) ◽  
pp. 301-303 ◽  
Author(s):  
M. Field ◽  
J. Pugh ◽  
J. Asquith ◽  
S. Davies ◽  
A.D. Pherwani
Keyword(s):  
Case Report ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
Insertion Site ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous Catheters ◽  
Central Venous

Background A growing number of hemodialysis patients are dependent upon central venous catheters (CVCs) for long-term vascular access. Although many complications of CVCs have been documented, the phenomenon of the stuck catheter is described relatively infrequently. Case report We describe a case where attempts to remove the line by exploration of the jugular insertion site in theater were unsuccessful and the line was internalized. Discussion The case is then discussed with all available cases in the literature to suggest principles of managing and preventing the stuck catheter phenomenon.

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