JAVA - Journal of the Association for Vascular Access最新文献

{"title":"Abstracts 7th World Congress on Vascular Access (WoCoVA) 2022 October 16 - 18, 2022","authors":"","doi":"10.1177/11297298221129234","DOIUrl":"https://doi.org/10.1177/11297298221129234","url":null,"abstract":"","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":"91 1","pages":"1 - 41"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75846590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of the Safety and Efficacy of Central Vascular Access Device Securement","authors":"Jon A. Bell, Michelle L Hawes, Emily Diloreto, S. M. Gibson","doi":"10.2309/java-d-22-00013","DOIUrl":"https://doi.org/10.2309/java-d-22-00013","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 Central vascular access devices (CVADs) are essential for patient care in modern medicine. Providing access to the central circulation, CVADs allow fluids and medications to be infused rapidly and hemodiluted. The placement of a CVAD requires knowledge of vascular access devices, optimal site selection, infection prevention protocols, and expert techniques to limit potential adverse outcomes. Research has been focused on how to safely and effectively place CVADs, but little effort has been made to investigate the securement of the catheter once it is in place.\u0000 \u0000 \u0000 \u0000 This systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered through PROSPERO. Two systematic searches of the literature were conducted, the first in January 2021 and the second in January 2022, by using multiple medical databases. Of the 1127 titles that met initial inclusion criteria 117 were selected for evaluation and then 39 for study.\u0000 \u0000 \u0000 \u0000 Search results yielded various outcomes, making a direct comparison between studies challenging. However, it was clear that safety and efficacy were not applied to suture-based securement and have not been well researched despite its general use.\u0000 \u0000 \u0000 \u0000 Randomized controlled studies are needed to measure the relative safety and efficacy of different securement modalities, their impact on CVAD complications, and ultimately patient outcomes.\u0000 \u0000","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46859545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Study of the Impact of a Head-Mounted Display and Probe Fixation for Ultrasound-Guided Peripheral Intravenous Cannulation","authors":"Nina Moors, Janne M.A. Dekkers, Tessa J.H.L. van de Wal, Johannus F.W.A. Peters, F. V. van Loon","doi":"10.2309/java-d-22-00014","DOIUrl":"https://doi.org/10.2309/java-d-22-00014","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 Ultrasound is an efficient and effective technique to aid intravenous cannulation, in which good hand-eye coordination is crucial. To reduce the difficulty, the ultrasound image should be projected and visible in front of the practitioner during cannulation, and the probe should be stabilized on the target vein. The current study investigates the impact of a head-mounted display and probe fixation for ultrasound-guided peripheral intravenous cannulation success and time needed to successful insertion.\u0000 \u0000 \u0000 \u0000 This nonclinical pilot study included 49 nurse anesthetists. They were divided into an intervention group (cannulation with a head-mounted display and probe stabilizer for ultrasound-guided peripheral intravenous cannulation, n = 24) and control group (conventional method of ultrasound-guided cannulation, n = 25). Participants performed 20 procedures each on phantoms, with focus on first attempt cannulation success and time taken to completion of successful cannulation.\u0000 \u0000 \u0000 \u0000 In the intervention group, 98% succeeded on their very first attempt at cannulation, compared to 52% in the control group (P < 0.001). Time to successful cannulation on the first attempt was 1.13 ± 0.4 minutes in the intervention group, compared with 1.69 ± 0.8 minutes in the control group (P = 0.003). Overall, first attempt cannulation success was 92% in the intervention group and 90% for the control group (P = 0.359). Times required for successful cannulation was reduced by 0.08 minutes in the intervention group (P < 0.001).\u0000 \u0000 \u0000 \u0000 This pilot study is the first describing the use of a head-mounted display and probe fixation for ultrasound-guided peripheral intravenous cannulation, which resulted in an increased success rate and decreased time to cannulation success.\u0000 \u0000","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44835958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Experience with a Power Injectable Arm Port","authors":"M. Wright, Navraj Dhaliwal, H. Le, B. Burbridge","doi":"10.2309/java-d-22-00007","DOIUrl":"https://doi.org/10.2309/java-d-22-00007","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 Background: Totally implanted venous access devices, or ports, are safe and durable, allowing for long-term venous access. Port insertion in the upper extremity is associated with high rates of technical success and few complications. This retrospective review evaluates complication rates of power injectable ports in the upper arm preformed at a tertiary academic institution.\u0000 Methods: A single center retrospective review of all patients undergoing arm port implantation between October 1, 2017, and January 30, 2019, were included. A minimum of 11 months of data was reviewed for each subject. A total of 165 subjects were initially enrolled.\u0000 Results: The most frequent indication for port insertion was malignancy (n = 157). Port insertion technical success rate was 99.4%. There was no significant difference in port-related complications by gender, malignancy, clinical indication for placement, or arm used for implantation. Rates of infection (5.5%), mechanical malfunction (6.7%), device removal (10%) and arterial injury (0%) were similar to previously reported values. The rate of port-related venous thrombosis was 8.6%, exceeding previously reported values.\u0000 Conclusion: Venous thrombosis was increased using this arm port. The polyurethane catheter material may play a role in this. Further work is warranted to investigate venous thrombosis for this device that incorporates information about insertion vein size and insertion vein characteristics.\u0000","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48967167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical and endovascular assisted maturation procedures improve cannulation after arteriovenous fistula creation, but not after arteriovenous graft placement.","authors":"M. Hafeez, R. Chaer, M. Eslami, O. Abdul-Malak, T. Yuo","doi":"10.1016/j.jvs.2022.03.671","DOIUrl":"https://doi.org/10.1016/j.jvs.2022.03.671","url":null,"abstract":"","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":"1 1","pages":"11297298231185793"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78316370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Different Flushing Frequencies on Peripheral Intravenous Catheter Failure, Coagulation, and Tissue Injury—A Counterbalanced Preclinical Human Trial","authors":"Samantha Keogh, A. Hawthorn, S. Shibeeb, Lauren Gurney, Evan N Pennell, S. Sabapathy, C. Rickard, A. Bulmer","doi":"10.2309/java-d-22-00006","DOIUrl":"https://doi.org/10.2309/java-d-22-00006","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 Peripheral intravenous venous catheters (PIVCs) are associated with a postinsertion failure incidence of 40%, yet the common maintenance and preventive strategy of saline flushing is poorly understood at a physiological level.\u0000 \u0000 \u0000 \u0000 We developed a human model of bilateral cephalic vein cannulation to study the impact of varied PIVC flushing frequency (high frequency, HF; low frequency, LF) over 5 hours on catheter failure (primary outcome), coagulation, platelet aggregation, and local tissue injury. Ultrasound was used in a subset to assess vascular diameter/catheter to vein, blood flow velocity, and thrombus formation.\u0000 \u0000 \u0000 \u0000 Out of 34 catheters in 17 adult participants, 1/17 (6%) LF catheters failed, which was not significantly different from HF catheters (0/17). Platelet function, activated partial thromboplastin time, and tissue factor were also not different (P > 0.05). However, prothrombin time (PT) increased with HF versus LF after 5 hours (P < 0.05). Ultrasound demonstrated luminal thromboses in veins experiencing both HF (6/7) versus LF (5/7) conditions after 5 hours with nonsignificant changes in vascular diameter and blood flow velocity over time. Conclusions: Although no difference in PIVC failure was observed between HF and LF flushing conditions over 5 hours, greater flushing frequency increased PT time, suggesting delayed activation or consumption of extrinsic coagulation factors. This study also demonstrated feasibility in assessment of luminal thromboses, which were remarkably prevalent after PIVC placement, and changes in vascular diameter and blood flow. This manuscript illustrates that the development of a sensitive human model will be of great use for exploring the impact of interventions on reducing PIVC failure in the future.\u0000 \u0000","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45205369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of antithrombotic treatment and bleeding disorders in patients requiring venous access devices: A systematic review and a GAVeCeLT consensus statement","authors":"M. Annetta, S. Bertoglio, R. Biffi, F. Brescia, I. Giarretta, A. Greca, N. Panocchia, Giovanna Passaro, F. Perna, F. Pinelli, M. Pittiruti, D. Prisco, T. Sanna, G. Scoppettuolo","doi":"10.1177/11297298211072407","DOIUrl":"https://doi.org/10.1177/11297298211072407","url":null,"abstract":"Insertion of venous access devices (VAD) is usually considered a procedure with low risk of bleeding. Nonetheless, insertion of some devices is invasive enough to be associated with bleeding, especially in patients with previous coagulopathy or in treatment with antithrombotic drugs for cardiovascular disease. The current practices of platelet/plasma transfusion in coagulopathic patients and of temporary suspension of the antithrombotic treatment before VAD insertion are based on local policies and are often inadequately supported by evidence, since many of the clinical studies on this topic are not recent and are not of high quality. Furthermore, the protocols of antithrombotic treatment have changed during the last decade, after the introduction of new oral anticoagulant drugs. Though some guidelines address some of these issues in relation with specific procedures (port insertion, etc.), no evidence-based document covering all the aspects of this clinical problem is currently available. Thus, the Italian Group of Venous Access Devices (GAVeCeLT) has decided to develop a consensus on the management of antithrombotic treatment and bleeding disorders in patients requiring VADs. After a systematic review of the available evidence, the panel of the consensus (which included vascular access specialists, surgeons, intensivists, anesthetists, cardiologists, vascular medicine experts, nephrologists, infective disease specialists, and thrombotic disease specialists) has structured the final recommendations as detailed answers to three sets of questions: (1) which is an appropriate classification of VAD-related procedures based on the specific bleeding risk? (2) Which is the appropriate management of the patient with bleeding disorders candidate to VAD insertion/removal? (3) Which is the appropriate management of the patient on antithrombotic treatment candidate to VAD insertion/removal? Only statements reaching a complete agreement were included in the final recommendations, and all recommendations were offered in a clear and synthetic list, so to be easily translated into clinical practice.","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":"41 1","pages":"660 - 671"},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90872881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Society for Diagnostic and Interventional Nephrology (ASDIN) 18th Annual Scientific Meeting (VIRTUAL) Abstracts","authors":"Monill-Raya, E. Macias-Toro, C. Rubiella, J. Merino, J. Vallesp, E. Criado, J. Guitart, A. Morell, Javier Serrano, J. Ibeas, Burguera Vion, G. R. Roso, R. Barrios, M. G. Vallejo, E. Ramírez, I. M. Capón, M. F. Lucas, M. R. Gorrín, V. B. Vion, Ana B. Saiz, Guillermo Conde","doi":"10.1177/11297298221093541","DOIUrl":"https://doi.org/10.1177/11297298221093541","url":null,"abstract":"Introduction: Transplantation (KTx) is considered the best renal replacement therapy and improving its outcomes remains a primary challenge. KTx ureteral JJ stenting has been used to prevent urological complications, but there is no consensus about EJJR timing and literature regarding routine US imaging after EJJR to detect complications is lacking. Aim: Define the incidence of urological complications diagnosed by routine US after EJJR in KTx, determine US utility and best time interval to perform it. Methods: We retrospectively analysed all routine KTx US performed in our Unit from 2016 until 2020 by an experienced interventional nephrologist. US post EJJR findings were compared with previous patient US. KTx characteristics, treatment and outcomes were recorded. Results: - 345 KTx were done, 62.9% were male receptors, 81.7% had a first KTx and 91.5% were from a deceased donor. No routine US post EJJR was done in 20.9% due to the COVID pandemic. - Mean timing to elective JJ stent removal was 36.4 ± 25 days (SD). - Mean time from EJJR to US was 16.3 ± 28.8 days (SD). - Urinary tract (UT) ectasia (19.7%) and grade I UT dilatation (3.6%) were not considered pathological. - 47.3% (129) had a complication detected: 88.4% (114) had a collection, 8.5% (11) had UTD: 5.4% grade II and 3.1% grade III. 3% had other complications. Conclusion: Routine US after EJJR allowed a timely diagnosis and early treatment of urological complications, a key factor for successful transplantation. KTx US is a cost - effective and reproducible test that provides crucial information to guide clinical decisions, being most efficient when performed 10 days post removal. Interventional nephrologists could do this examination promptly.","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":"33 1","pages":"NP1 - NP7"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73297354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Central Line Securement Vest to Prevent Mechanical Complications of Tunneled Central Lines: Experience from a Cohort of Pediatric Patients with Intestinal Failure","authors":"Ryan St Pierre-Hetz, K. Ackerman, Christian P. Dresser, J. A. Yaworski, Angelica Cercone, J. Rudolph, S. Wisniewski, Mioara D. Manole","doi":"10.2309/java-d-21-00028","DOIUrl":"https://doi.org/10.2309/java-d-21-00028","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 Tunneled central lines are used to deliver medications, hydration, and total parenteral nutrition. The current modality for their securement is by a transparent sterile adhesive. Mechanical line traumas, including line fissures, breaks and dislodgements, occur frequently in children. A novel device, the Central Line Securement Vest, was created to protect central lines from mechanical trauma.\u0000 \u0000 \u0000 \u0000 We present here our experience with the device and report its use in patients with intestinal failure treated at our institution.\u0000 \u0000 \u0000 \u0000 All patients who have used the Central Line Securement Vest at our institution during the last decade were identified. We reviewed the patients’ electronic records and compared the rate of line mechanical trauma, line infections, line replacements, Emergency Department (ED) visits, and hospital admissions for a period of 12 months before and after the use of the device.\u0000 \u0000 \u0000 \u0000 Ten patients were identified. Four patients had purchased the device at the time of line insertion. Six patients had a period of time of line use before beginning use of the device. The rate of line traumas and infections decreased after using the device: 0.19 ± 0.15 vs 0.05 ± 0.04 trauma/month, pre– vs post–device use, P < 0.05. Similarly, the rate of line infections decreased post–device use: 0.18 ± 0.13 vs 0.09 ± 0.06 infections/month, pre– vs post–device use, P < 0.05. The rate of line replacements, ED visits, and hospital admissions were similar pre– and post–device use.\u0000 \u0000 \u0000 \u0000 We report here our institution’s experience with a novel central line securement device designed to protect the line from mechanical trauma.\u0000 \u0000","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44849706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"President’s Message","authors":"Tonja Stevens","doi":"10.2309/java-2022.27-01-03","DOIUrl":"https://doi.org/10.2309/java-2022.27-01-03","url":null,"abstract":"","PeriodicalId":35321,"journal":{"name":"JAVA - Journal of the Association for Vascular Access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43337251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}