Operative and perioperative management of infected arteriovenous grafts

2016 ◽  
Vol 18 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Ehsan Benrashid ◽  
Linda M. Youngwirth ◽  
Leila Mureebe ◽  
Jeffrey H. Lawson

Vascular graft infections are a particularly troublesome complication for dialysis patients, many of whom are in an already immunocompromised state. The objective of this review is to detail the risk factors, etiology, diagnosis, perioperative and operative management of vascular graft infections.

VASA ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 466-472 ◽  
Author(s):  
Chia-Hsun Lin ◽  
Yen-Yang Chen ◽  
Chai-Hock Chua ◽  
Ming-Jen Lu

Abstract. Background: In this study, we investigated the patency of endovascular stent grafts in haemodialysis patients with arteriovenous grafts, the modes of patency loss, and the risk factors for re-intervention. Patients and methods: Haemodialysis patients with graft-vein anastomotic stenosis of their arteriovenous grafts who were treated with endovascular stent-grafts between 2008 and 2013 were entered into this retrospective study. Primary and secondary patency, modes of patency loss, and risk factors for intervention were recorded. Results: Cumulative circuit primary patency rates decreased from 40.0 % at 6 months to 7.3 % at 24 months. Cumulative target lesion primary patency rates decreased from 72.1 % at 6 months to 22.0 % at 24 months. Cumulative secondary patency rates decreased from 81.3 % at 12 months to 31.6 % at 36 months. Patients with a history of cerebrovascular accident had a significantly higher risk of secondary patency loss, and graft puncture site stenosis jeopardised the results of stent-graft treatment. Conclusions: Our data can help to improve outcomes in haemodialysis patients treated with stent-grafts for venous anastomosis of an arteriovenous graft.


2009 ◽  
Vol 27 (1) ◽  
pp. 59-61
Author(s):  
E Indhumathi ◽  
V Chandrasekaran ◽  
D Jagadeswaran ◽  
M Varadarajan ◽  
G Abraham ◽  
...  

2005 ◽  
Vol 65 (8) ◽  
pp. 739-745 ◽  
Author(s):  
F. M. Yilmaz ◽  
G. Yilmaz ◽  
M. Duranay ◽  
H. Parpucu ◽  
M. Şeneş ◽  
...  

Renal Failure ◽  
2007 ◽  
Vol 29 (7) ◽  
pp. 835-841 ◽  
Author(s):  
Wen-Hung Huang ◽  
Yung-Chang Chen ◽  
Cheng-Chieh Hung ◽  
Jeng-Yi Huang ◽  
Ja-Liang Lin ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Madiha Iqbal ◽  
Rabia Saleem ◽  
Salman Ahmed ◽  
Prachi Jani ◽  
Salvador Alvarez ◽  
...  

Phlegmonous gastritis is an uncommon acute bacterial infection of the stomach that carries a fatal prognosis in spite of the advent of antibiotics. A high index of suspicion is required in patients with risk factors. An immunocompromised state is identified as one of the most important risk factors. We hereby report a case of successful antimicrobial treatment of phlegmonous gastritis in a patient who was receiving intensive chemotherapy for acute myelogenous leukemia. We have also carried out a review of literature over the past ten years. Streptococcus pyogenes is identified as the most common causative organism, and patient presentation is usually nonspecific. Conservative treatment with prompt institution of antibiotics can lead to rapid resolution in the majority of patients.


2003 ◽  
Vol 131 (9-10) ◽  
pp. 382-388 ◽  
Author(s):  
Tatjana Damjanovic ◽  
Nada Dimkovic

Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis), in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I,30 on hemodialysis, group II) and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0,720 mm) and group B (intima media thickness higher then 0,720mm). Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.


2016 ◽  
Vol 39 (4) ◽  
pp. 111 ◽  
Author(s):  
Nuran Cetın ◽  
Nadide M Sav ◽  
Duran Karabel ◽  
Ali Yildirim ◽  
Bilal Yıldız

Purpose: Cardiovascular diseases are the main causes of morbidity and mortality in children with end-stage renal disease and the relationships among several relevant potential biomarkers were investigated in pediatric peritoneal dialysis patients. Methods: Serum homocysteine, von Willebrand factor (vWF), apolipoproteins A and B, lipoprotein-a, high sensitive-CRP, hemoglobin, phosphorus and parathyroid hormone (PTH) levels, systolic (SBP) and diastolic (DBP) blood pressure, carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI) were measured in 21 pediatric peritoneal dialysis patients and control subjects. Results: All risk factors were higher in patients than controls. LVMI values were negatively correlated with hemoglobin and positively correlated with PTH and phosphorus levels (p=0.007, r= - 0.573; p=0.013, r= 0.532 and p=0.035, r= 0.461, respectively). cIMT was negatively associated with serum albumin and positively correlated with vWF levels and with SBP and DBP (p=0.006, r= - 0.578; p=0.039, r= 0.453; p=0.02, r= 0.503; p=0.024, r= 0.491, respectively). Robust regression analyses showed that hemoglobin was an independent predictor of LVMI and serum albumin was an independent predictor of cIMT. Conclusion: Only uremia-related factors were independent risk factors for predicting LVMI and cIMT. Hemoglobin level may be a critical factor in the development of left ventricular hypertrophy; therefore, effective treatment of anemia is crucial. Low serum albumin and high hsCRP and vWF levels, and their correlations with cIMT, indicate these patients could be at risk of developing malnutrition–inflammation–atherosclerosis syndrome and suggest that serum albumin and vWF levels may be useful markers for early detection of vascular damage.


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