scholarly journals Vascular access parameters among prevalent dialysis patients: a single center survey

2020 ◽  
Vol 10 (2) ◽  
pp. 120-124
Author(s):  
Tanveer Bin Latif ◽  
Tanvir Rahman
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Similar Data ◽  
Age Group ◽  
Dialysis Unit ◽  
Medical Graduates ◽  
Number Of Patients ◽  
Venous Fistula ◽  
Access Surgery

Background: Vascular access is one of the most important outcome determinant of patients on hemodialysis. In Bangladesh increasingly more patients are started on hemodialysis as a lifesaving procedure. But we lack organized data on different aspects of dialysis practice. Data related to vascular access is even more scanty. Method: A survey was undertaken in one of the busy dialysis centers in Dhaka with a large number of patients on maintenance hemodialysis .Data were collected by doctors in dialysis units from patients along with records kept in the dialysis unit during November and December 2017. Results: Total 143 patients were included. 53% of these patients belonged to age group 61 to 80 years, 39% to age group 41 to 60 years; 56.6 % female and 43.4% male. 73.4% of the study patients received dialysis via central venous catheter at the initiation. But among the prevalent patients during study period, 84% patient were receiving dialysis via arterio-venous fistula and 5% via arterio-venous graft as permanent vascular access. Among these permanent vascular access left forearm was used in 47% and left upper arm in 33% of cases. Vascular ultrasound mapping before permanent access creation was done in only about 40% of cases. Almost 56 % of the vascular access surgery was done by experienced medical graduates in vascular access creation without any post graduate surgical qualifications. Conclusion: Vascular access data should be collected in a structured manner so that dialysis practice pattern of different centers and regions of the country can be compared. Similar data from several centers around the country will increase scope of improvement . Birdem Med J 2020; 10(2): 120-124

scholarly journals Hemodialysis vascular access in children – A retrospective study in a pediatric dialysis unit

2021 ◽  
Vol 35 (3) ◽  
Author(s):  
Gabriela Teixeira ◽  
◽  
Paulo Almeida ◽  
Norton Matos ◽  
Maria Faria ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Vascular Access ◽  
Failure Time ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Central Venous ◽  
Dialysis Unit

Objective: Permanent access in the form of a fistula is the preferred form of vascular access for most pediatric patients on maintenance hemodialysis (HD) therapy; however, the technical aspects of the procedure that are unique to the pediatric population, the expectation of a short waiting time for kidney transplantation and the need to cannulate every other day (with the pain and fear associated with it) limit its use. Our objective was to analyze the long-term outcomes of pediatric arteriovenous fistulas in our institution. Methods: A retrospective review was performed of all arteriovenous fistula (AVF) created in a HD population aged 0 to 18 years at a single institution from 2007 to 2019. Data abstracted included age, weight, etiology of renal failure, time on dialysis, central venous catheter history and transplantation history. Data were analyzed to determine the primary and secondary patency. Results: During the study period, 19 AVFs were performed in 16 patients, of whom 9 patients (56.3%) were male. Mean patient age was 12.3 years (range 5-17 years), and mean weight was 38.3kg (range 12-83kg). At the time of AVF creation, 9 patients were on dialysis and 7 patients had a central venous catheter (CVC), with a median length of CVC dependence of 10 months. Procedures performed included 4 radiocephalic fistulas, 11 brachiocephalic fistulas and 4 brachiobasilic. Five accesses failed to mature (26.3%). Mean follow-up was 6 years. The 2-year primary and secondary patency rates were 92.3% and 100%, respectively. The 4-year primary and secondary patency rates were 76.9% and 100%, respectively. No thrombosis was documented during follow-up. During the postoperative period, 10 patients (62.5%) received a kidney transplant, in a mean time of 23 months. Conclusions: AVFs demonstrate excellent long-term patency in pediatric HD patients. No significant complications were reported and no thrombosis occurred.

P1366THE ROLE OF A NEPHROLOGIST IN THE CREATION OF VASCULAR ACCESS FOR HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gennadii Fomenko
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Access ◽  
Kidney Diseases ◽  
Kidney Injury ◽  
Venous Catheter ◽  
Vascular Surgeon ◽  
Dialysis Unit ◽  
The Creation ◽  
Set Up

Abstract Background and Aims The creation of vascular access: has it anything to do with a nephrologist ? At first glance, the concept of vascular access is the responsibility of surgical specialists. However, a nephrologist has started executing some of the common intensive treatment methods, using the equipment and techniques, specific to the field of dialysis. In this case, a nephrology specialist sets up different kinds of vascular access, namely the AV (arteriovenous) fistula, the AV graft, and the venous catheter; he/she is, therefore, responsible for its assessment and congruent correction. Method the usage of statistical data, gathered by the medical specialists of the dialysis unit of the Regional Chernihiv Hospital; the analysis of the possible nephrologist’s contribution to the creation of vascular access in patients with kidney diseases. Results During 2017-2019, 332 catheterizations were performed, during each of them vascular access was established: Conclusion 1. A nephrologist, in collaboration with a vascular surgeon, is particularly interested in the creation of vascular access in a patient with chronic kidney disease at the pre-dialysis stage; 2. In most cases, a nephrologist can set up temporary or permanent vascular access in patients with chronic kidney disease or acute kidney injury, which improves the quality of hemodialysis by making him an active participant of the treatment process.

Vascular Access Surgery for Maintenance Hemodialysis

ASAIO Journal ◽  
1992 ◽  
Vol 38 (2) ◽  
pp. 113-115 ◽  
Author(s):  
Joan D. Mayers ◽  
Mariana S. Markell ◽  
Linda S. Cohen ◽  
Joon Hong ◽  
Peter Lundin ◽  
...  
Keyword(s):  
Vascular Access ◽  
Maintenance Hemodialysis ◽  
Vascular Access Surgery ◽  
Access Surgery

Vascular Access Surgery for Maintenance Hemodialysis Variables in Hospital Stay

ASAIO Journal ◽  
1992 ◽  
Vol 38 (2) ◽  
pp. 113-115 ◽  
Author(s):  
JOAN D. MAYERS ◽  
MARIANA S. MARKELL ◽  
LINDA S. COHEN ◽  
JOON HONG ◽  
PETER LUNDIN ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Vascular Access ◽  
Maintenance Hemodialysis ◽  
Vascular Access Surgery ◽  
Access Surgery

Outpatient Vascular Access Surgery: Impact of a Dialysis Unit-Based Surgical Facility

1992 ◽  
Vol 19 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Ralph Didlake ◽  
Edna Curry ◽  
Edward E. Rigdon ◽  
Seshadri Raju ◽  
John Bower
Keyword(s):  
Vascular Access ◽  
Dialysis Unit ◽  
Vascular Access Surgery ◽  
Access Surgery

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.

The past and the future of vascular access surgery: Creation of percutaneous arteriovenous fistula using Ellipsys vascular access system in a patient with previous ipsilateral Scribner-shunt

2020 ◽  
pp. 112972982096932
Author(s):  
Robert Shahverdyan ◽  
Klaus Konner ◽  
Vladimir Matoussevitch
Keyword(s):  
Vascular Access ◽  
Volume Flow ◽  
Vascular Access Surgery ◽  
Successful Case ◽  
The Creation ◽  
Venous Fistula ◽  
Short Time ◽  
Vein Stenosis ◽  
Access Surgery

Background: Sixty years after the first description of Scribner-shunt, and 54 years after publication of the first radio-cephalic arterio-venous fistula (AVF), endovascular percutaneous AVF (pAVF) was introduced. We report a successful case of Ellipsys-pAVF creation and use for hemodialysis in a patient with a previous ipsilateral Scribner-shunt. Case: A 72-year old female patient with chronic kidney disease (CKD), previous right-sided Scribner-shunt and kidney transplant, underwent a successful creation of right-sided Ellipsys-pAVF. The procedure time was 12 min with intraoperative brachial artery volume flow of 720 ml/min. At 39 days, an ultrasound-guided balloon-angioplasty of the outflow cephalic vein stenosis was performed. Cannulations were started 41 days after the creation of pAVF. No additional interventions were required during the follow-up of 258 days with last follow-up volume flow of 1400 ml/min. Conclusions: This is the first report of the creation of pAVF in a patient with previous “traumatic” ipsilateral placement of a Scribner-shunt. It allows the creation of a small anastomosis in very short time, which can be successfully used for hemodialysis treatment on the same day, if necessary, and reduces the expected risk of high-flow AVF with associated peripheral steal and cardiac outcomes (especially in a patient with cardiomyopathy such this one).

Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft?

2019 ◽  
Vol 21 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Nicholas Inston ◽  
Aurangzaib Khawaja ◽  
Hiren Mistry ◽  
Robert Jones ◽  
Domenico Valenti
Keyword(s):  
Vascular Access ◽  
Treatment Options ◽  
Venous Catheter ◽  
Right Atrial ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Arterial Access ◽  
Secondary Patency Rate ◽  
Number Of Patients ◽  
End Stage

Background: Running out of vascular access for dialysis is thankfully rare, but despite this, most units will have a number of patients with few options and in a precarious state. The increasing longevity of dialysis patients portends more patients will reach minimal access options. End stage vascular access is poorly defined but classification may enable assessment and comparison of treatment options. Three options for patients with end stage access are a central venous catheter through a translumbar or transhepatic route, arterial-arterial prosthetic loop or a right atrial graft. Aims: The aims of this study are to provide a structured review of evidence for these procedures to allow application and guide practice for patients with end stage vascular access. Methods: A standardised search of published literature was performed of relevant studies. In addition, the references cited in those papers were assessed for any further available articles. All study types were included and reviewed by two authors independently. Primary outcomes were patient survival and secondary patency rate at 3 and 12 months. Secondary outcomes were long-term patency rates, mean time to cannulation and complications such as access dysfunction, thrombosis and infection. Summary: Based on the available evidence, it would appear that arterial-arterial prosthetic loop is a definitive option for maintaining dialysis access in patients with no more arteriovenous access options. Translumbar and transhepatic dialysis catheters may offer short- and medium-term options and right atrial grafts may also be suitable as an option where arterial-arterial prosthetic loop is unsuitable.

scholarly journals Vascular Access Profile of End Stage Renal Disease Patients on Maintenance Hemodialysis: Experience from a Tertiary Care Center of Bangladesh

2019 ◽  
Vol 7 (1) ◽  
pp. 26-28
Author(s):  
Md Mostarshid Billah ◽  
Md Anisur Rahman ◽  
Muhammad Abdur Rahim ◽  
Tufayel Ahmed Chowdhury ◽  
Md Abdul Latif ◽  
...  
Keyword(s):  
Vascular Access ◽  
Care Center ◽  
Tertiary Care ◽  
Study Participant ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Femoral Catheter ◽  
Av Fistula

Background: A well-functioning vascular access (VA) is essential to provide efficient hemodialysis (HD) therapy. There are 3 main types of access: arterio-venous fistula (AVF), arterio-venous graft (AVG) and central venous catheter (temporary or permanent). The aim of our study was to find vascular access profile of ESRD patients on maintenance hemodialysis in a tertiary care hospital. Methods: This cross-sectional study was carried out in the Department of Nephrology and Dialysis of BIRDEM General Hospital, Dhaka, Bangladesh from November to December, 2015. After taking informed consent from the patients, data were collected from face to face interview and record books of the patients. Results: Total patients were 107, male were 78 (72.9 %) and female were 29 (27.1%). The mean age was 57.3 ± 11.4 (range 32-80) years. Mean duration of CKD was found 5.7 ± 4.2 (range 1-20) years. Maximum dialysis duration was 6.5 years with mean of 1.7 ± 1.3 years. Near two-thirds (68.2%) of the patients were on thrice-weekly dialysis and one-third (31.8%) were on twice-weekly dialysis. The vascular access at initiation of dialysis was temporary catheter in majority (91.6%) of study participant and AV fistula in 8.4% cases. Of temporary catheter one-third (33.7%) were temporary jugular catheter and two-third (66.3%) were temporary femoral catheter. Among jugular catheter 9.1% were left sided catheter and rest (90.9%) were right sided catheter. Among the femoral catheter 70.8% and 29.2% were right and left side respectively. The current vascular access was AV fistula in 90.7%, temporary catheters 4.7%, permanent catheter 3.7% and AVG 0.9% in study patients. Of AVF near one third (29.9%) were radio-cephalic and 70.1% were brachial (62.6% brachio-cephalic, 7.5% brachio-basilic) fistulas. About seventeen percent (16.8%) patients had AVF failure. Conclusion: Temporary dialysis catheters were the most common initial vascular access. Less than one-tenth patients started dialysis with AV fistula. More than two-thirds patients were on thrice weekly dialysis. AV fistula was the most common current vascular access with very small number of permanent catheter and AV graft. Bangladesh Crit Care J March 2019; 7(1): 26-28

scholarly journals Anticoagulation treatments related different types of vascular access on maintenance hemodialysis patient: A multicenter epidemiological investigation

2015 ◽  
Vol 3 (2) ◽  
pp. 68-73
Author(s):  
Qi Huang ◽  
Xue-Feng Sun ◽  
Hong-Li Lin ◽  
Zhi-Min Zhang ◽  
Li-Rong Hao ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Evaluation Studies ◽  
Venous Catheter ◽  
Maintenance Hemodialysis ◽  
Epidemiological Investigation ◽  
Targeted Treatments ◽  
Thrombotic Complications ◽  
Catheter Lock ◽  
Risk Of Hemorrhage

Abstract Objective: The objective was to increase the understanding of vascular access in hemodialysis and evaluate hemodialysis-related anticoagulation treatments and the associated hemorrhagic or thrombotic complications. Materials and Methods: In this study, an epidemiological investigation was conducted in 1175 patients who underwent hemodialysis in seven blood purification centers in northern Chinese. The patients were divided into two groups based on the vascular access they used: Arteriovenous fistula (AVF) group and central venous catheter (CVC) group. The similarities and differences of anticoagulation and hemorrhagic, thrombotic complications were compared between two groups. Results: Arteriovenous fistula was the most frequently used vascular access, and heparin was the most commonly used anticoagulant. Patients in CVC group experienced significantly greater rates of low molecular weight heparin (LMWH) administration and had a higher rate in achieving thrombotic complications than those in AVF group. There were no significant differences in LMWH dosages in patients with thrombotic complications, as well as the proportion of patients who received anti-platelet drugs. Heparinized catheter lock solutions were excessively high in this study, which may lead to a risk of hemorrhage. Conclusion: Hemodialysis-related anticoagulation treatments in China require additional improvements, especially for the patients using CVC as vascular access. There is an urgent need to develop clinical evaluation studies of anticoagulation treatments for achieving more standardized and targeted treatments.

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