Journal of Vascular Access最新文献

{"title":"Robotic assisted central catheter placement feasibility and emergency medicine implications.","authors":"Yalcin Golcuk","doi":"10.1177/11297298251340204","DOIUrl":"https://doi.org/10.1177/11297298251340204","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251340204"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insertion of midline catheters in critically ill patients with limb trauma and fractures: Feasibility and case report.","authors":"Tian Tian, Yang Liu, Lin Tan, Yi Lu","doi":"10.1177/11297298251342876","DOIUrl":"https://doi.org/10.1177/11297298251342876","url":null,"abstract":"<p><p>This article reports a critically ill patient with extremity fractures caused by a traffic accident. Given the severity of the patient's condition and the specific nature of the fractures, after a thorough evaluation of the fracture sites, a midline catheter was placed in the affected side's upper arm through ultrasound guidance as a vascular access solution. The catheter was safely retained for 63 days, completing the entire treatment cycle without any related complications, providing stable and reliable vascular access support for the patient's overall treatment. This case demonstrates the feasibility of using midline catheters in critically ill patients with extremity fractures, offering new perspectives and references for the selection of vascular access in these patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342876"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracavitary ECG versus X-ray guidance for central venous access device tip location: A cost-effectiveness analysis.","authors":"Fulvio Pinelli, Filippo Firenzuoli, Stefano Romagnoli, Marta Mazzella, Daniela Matarrese, Elvira Bianco, Valentina Gigli, Gianluca Villa","doi":"10.1177/11297298251345989","DOIUrl":"https://doi.org/10.1177/11297298251345989","url":null,"abstract":"<p><strong>Background: </strong>Intracavitary ECG (IC-ECG) for central venous access devices (CVADs) tip location is one of the most significant innovations in the field of venous access in recent years. Despite there is evidence demonstrating its effect in improving outcomes, data regarding its cost-effectiveness are still scarce.</p><p><strong>Methods: </strong>We conducted a retrospective observational study at a tertiary care Italian hospital comparing IC-ECG versus fluoroscopy plus postprocedural chest X-ray (CXR) and IC-ECG versus postprocedural CXR for port and peripherally inserted central catheters (PICC) tip location respectively. The primary outcome was to assess the impact of the adoption of IC-ECG versus radiological tip location on annual cost reduction.</p><p><strong>Results: </strong>Between January 1st and December 31st, 2022, 1722 medium-long term CVADs (753 ports and 969 PICC) were placed at the authors' Vascular Access Center. Costs of single port insertion using fluoroscopy plus CXR or IC-ECG for tip location were €921,04 and €351,42 respectively, with a net saving of €569,62 per procedure in favor of IC-ECG. Costs of a single PICC insertion using postprocedural CXR and IC-ECG for tip location were €364,38 and €320,85 respectively, with a net saving of €43,53 per procedure in favor of IC-ECG. Costs related to primary malpositioning were also calculated, being €926,17 and €52.962,63 for port and PICC respectively. Based on the authors' annual volume of CVAD placements, annual savings by utilizing IC-ECG instead of fluoroscopy for port tip location and IC-ECG instead of post procedural CXR for PICC tip location, were €425.836,58 and €92.361,97 respectively, with an overall net total saving of €518.198,55.</p><p><strong>Conclusion: </strong>Utilizing IC-ECG instead of X-ray guidance (CXR or fluoroscopy) for medium and long term CVAD tip location (PICC and port) has resulted in significant cost reduction. This strategy should strongly be considered for improving the cost-effectiveness of CVADs implantation.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345989"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removing a Tenckhoff catheter.","authors":"Julian Yaxley","doi":"10.1177/11297298251340198","DOIUrl":"https://doi.org/10.1177/11297298251340198","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251340198"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of residual anastomotic thrombus during surgical thrombectomy and endovascular intervention for arteriovenous graft thrombosis.","authors":"Kentaro Kasa, Takao Ohki, Kota Shukuzawa, Soichiro Fukushima, Hirotsugu Ozawa, Makiko Omori, Miyo Shirouzu, Hikaru Nakagawa, Ryo Nishide","doi":"10.1177/11297298251345992","DOIUrl":"https://doi.org/10.1177/11297298251345992","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical impact of residual thrombus at the anastomotic site during surgical thrombectomy and endovascular intervention for arteriovenous graft (AVG) thrombosis.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study reviewed 203 consecutive cases of vascular access thrombosis treated between January 2015 and December 2023. Among them, 43 cases of AVG thrombosis with a first-time occlusion and successful revascularization were included for analysis. A per-protocol analysis focusing on postintervention outcomes was conducted among patients who underwent surgical thrombectomy and/or endovascular intervention. Residual anastomotic thrombus was assessed on intraoperative final angiography. All cases were divided into those with residual anastomotic thrombus and those without. The primary outcome measure was postintervention assisted primary patency (PAPP). In addition, hazard ratios of each variable for postintervention patency were evaluated using univariate and multivariate analysis.</p><p><strong>Results: </strong>All 43 patients were divided into two groups: 12 patients (27.9%) with residual anastomotic thrombus and 31 patients (72.1%) without residual anastomotic thrombus. During a median follow-up period of 19 months, PAPP was significantly lower in cases with residual anastomotic thrombus than those without (residual thrombus: 38.1% at 90 days, 19.1% at 180 days, and 19.1% at 365 days; non-residual thrombus: 93.2% at 90 days, 85.7% at 180 days, and 74.6% at 365 days; log-rank <i>p</i> < 0.0001). There was no significant difference in postintervention secondary patency between cases with residual anastomotic thrombus and those without (residual thrombus: 75.0% at 90 days, 65.6% at 180 days, and 65.6% at 365 days; non-residual thrombus: 96.8% at 90 days, 96.8% at 180 days, and 93.1% at 365 days; log-rank <i>p</i> = 0.148). Multivariate analysis identified residual thrombus as an independent risk factor for PAPP (hazard ratio 5.57; 95% confidence interval 2.40-12.93; <i>p</i> < 0.0001), as well as variables including endovascular intervention.</p><p><strong>Conclusion: </strong>AVG thrombosis with residual thrombus at the anastomotic site during intervention showed significantly lower PAPP than those without. Residual anastomotic thrombus may be a relevant factor associated with patency outcomes, and further prospective evaluation is warranted to assess its utility as a treatment endpoint of intervention for AVG thrombosis.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345992"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of inflammatory biomarkers for arteriovenous fistula failure: A systematic review and meta-analysis.","authors":"Marília Oberto da Silva Gobbo, Tanize Louize Milbradt, Alexandre Yamada Fujimura Júnior, Renan Yuji Ura Sudo, Mariane Amado de Paula, Jarbas Rodrigues de Oliveira, Carlos Eduardo Poli-de-Figueiredo","doi":"10.1177/11297298251345510","DOIUrl":"https://doi.org/10.1177/11297298251345510","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis requires reliable vascular access, and arteriovenous fistulas (AVF) are preferred for their superior patency and fewer complications. However, AVF failure remains high, with 50% becoming nonfunctional within 2 years. Inflammatory biomarkers can contribute to AVF failure, yet the specific biomarkers involved remain to be identified.</p><p><strong>Aim: </strong>We aim to determine the prognostic significance of inflammatory biomarkers in predicting primary AVF failure in hemodialysis patients.</p><p><strong>Methods: </strong>The electronic search was performed in different databases: PubMed, Embase, and Cochrane Library, from inception to June 2024. Statistical analysis was performed using R software 4.3.1. A random-effects model was employed to compute mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI) for continuous and binary endpoints. The results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guideline.</p><p><strong>Results: </strong>A total of 15 studies, encompassing 1809 patients with a mean age of 62 years, were included. Over follow-up ranging from 6 weeks to 26 months, we did not observe a significant difference in the levels of monocyte chemotactic protein 1 (MCP-1; 12.15 pg/mL; 95% CI -14.26 to 38.56; <i>p</i> = 0.37), tumor necrosis factor alpha (TNF-α; 0.90 pg/mL; 95% CI -38.77 to 40.57; <i>p</i> = 0.96) and white blood cells (WBC; 0.31 g/L; 95% CI -0.05 to 0.66; <i>p</i> = 0.09) between the group experiencing AVF maturation and those facing AVF failure. However, there was a significant elevation in C-reactive protein (CRP) levels in the AVF failure group (2.89 mg/L; 95% CI 0.31-5.47; <i>p</i> = 0.03).</p><p><strong>Conclusions: </strong>Despite the increased CRP values within the AVF failure cohort and the significance noted in individual studies, our investigation did not find discernible effects attributable to other inflammatory and fibrotic biomarkers.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345510"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided placement of central venous catheters in neonates weighing less than 500 g: A case report.","authors":"Carmen Rodriguez-Perez, Elena Pezzotti, Chiara Iacono, Francesco Maria Risso","doi":"10.1177/11297298251345311","DOIUrl":"https://doi.org/10.1177/11297298251345311","url":null,"abstract":"<p><p>Parenteral nutrition (PN) is a vital treatment for critically ill newborns. Inserting a central venous catheter in a neonate to administer PN and other solutions and drugs incompatible with the peripheral route is crucial and is an urgent procedure. Dislocation or loss of the central vascular catheter implies the placement of a new device, and the inability to insert it may become a clinical emergency in this vulnerable population. We describe the insertion technique of an ultrasound-guided non-tunneled centrally inserted central catheter (CICC) placed in an extremely low-weight and extremely preterm neonate, adapting materials used for placing vascular access devices in the superficial veins of neonates.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345311"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifteen years and counting: A journey of interventions to sustain an arteriovenous graft hemodialysis access.","authors":"Rita Piedade, Jorge Costa-Lima, Jose Miguel Vilas-Boas, Lara Dias, Diogo Domingues-Monteiro, Leandro Nóbrega, Joana Ferreira, Luis Coentrão, Armando Mansilha","doi":"10.1177/11297298251344674","DOIUrl":"https://doi.org/10.1177/11297298251344674","url":null,"abstract":"<p><p>Vascular access (VA) maintenance is challenging in complex dialysis patients, where patient-centered approaches are decisive. Arteriovenous grafts (AVGs) provide an alternative for those unsuitable for autogenous arteriovenous fistula (AVF). However, AVFs and AVGs are prone to complications such as stenosis, aneurysm, and thrombosis, leading to dysfunction and morbidity in these patients. This report focuses on the journey of an extraordinary longevity of a 15-year-old AVG in a 54-year-old female patient, detailing multiple interventions required to maintain its patency. The case also underscores the role of a multidisciplinary team in achieving long-term success.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251344674"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of multidisciplinary vascular access team creation in incident dialysis patients: A retrospective case-control study.","authors":"Rafael Figueiredo, Miguel Relvas, Hugo Diniz, Joana Ferreira, Jorge Costa Lima, Armando Mansilha, Manuel Pestana, Luís Coentrão","doi":"10.1177/11297298251344069","DOIUrl":"https://doi.org/10.1177/11297298251344069","url":null,"abstract":"<p><strong>Background: </strong>Autologous arteriovenous fistulae (AVF) are the vascular access (VA) of choice for most hemodialysis (HD) patients. Creating multidisciplinary VA teams (MDT) may improve access-related outcomes and patient survival. This study aims to evaluate our center's MDT impact on matured AVFs.</p><p><strong>Methods: </strong>A retrospective case-control analysis was performed, comparing our center's incident HD patients from years 2022 and 2019. An MDT was created in 2021. Patient data was collected from their electronic health record. The primary outcome was the VA typology used for HD initiation. Secondary outcomes were the prevalence of functioning AVFs 12 months after HD initiation and 24-month patient mortality. Clinical predictors of mortality were derived from a combined-year Cox proportional hazard regression model.</p><p><strong>Results: </strong>One hundred and sixty-nine and 184 incident HD patients were included from 2022 and 2019, respectively. There were no significant differences regarding demographic variables, comorbidities, prior nephrology and VA appointments, patients with VA constructed, and the number of non-programmed HD initiations. The number of patients starting HD with a matured AVF was higher in 2022 (50.9% vs 37.5%, <i>p</i> = 0.011), regardless of demographic variables and comorbidities. The number of functioning AVFs at the 12th month of HD was also greater in 2022 (85.2% vs 76.6%, <i>p</i> = 0.041). The cumulative number of AV interventions until 12 months post-HD was similar between years, with fewer AV construction surgeries in 2022 (<i>p</i> < 0.001). Primary patency (<i>p</i> = 0.020) and secondary patency (<i>p</i> < 0.001) were higher in 2022. The 24-month cumulative mortality was lower in 2022 (17.8% vs 27.2%, <i>p</i> = 0.041), with no significant differences regarding the categorized cause of death. In our combined-cohort multivariable analysis, previous myocardial infarction (HR 1.86, <i>p</i> = 0.034) and dementia (HR 2.61, <i>p</i> = 0.016) were predictors of 24-month mortality. VA construction (HR 0.36, <i>p</i> = 0.013) was a negative predictor.</p><p><strong>Conclusion: </strong>In our center, the MDT creation was associated with a significantly increased number of matured AVFs at HD initiation and after 12 months of HD. Twenty-four-month patient mortality was lower post-MDT creation.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251344069"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic vertebro-jugular fistula: Case report.","authors":"Aravindhmozhi P, Charankumar Swamikkannu, Kalpana Sivalingam, Mohanraj Periyasamy, Rinesh Kochummen, Sakthirajan Ramanathan, Natarajan Gopalakrishnan","doi":"10.1177/11297298251342296","DOIUrl":"https://doi.org/10.1177/11297298251342296","url":null,"abstract":"<p><p>Internal jugular vein (IJV) cannulation is one of the most commonly used procedure in intensive care units and hemodialysis setting. With ultrasound-guided cannulations, the incidence of complications has significantly decreased. We report a patient who developed vertebro-jugular fistula post internal jugular vein cannulation and was successfully treated with a stent graft placed using an endovascular technique. In the literature, very few similar cases have been reported so far.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342296"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}