Journal of Vascular Access最新文献

{"title":"Ultrasound-guided cannulation of the brachiocephalic vein in neonates: Feasibility and safety.","authors":"Oussama Mghirbi, Mariem Barka, Donia Brahem, Maha Taamli, Amani Khlifi, Sonia Merchaoui, Nabiha Mahdhaoui","doi":"10.1177/11297298251349037","DOIUrl":"https://doi.org/10.1177/11297298251349037","url":null,"abstract":"<p><strong>Introduction: </strong>Central venous catheter placement (CVC) in the neonatal population poses significant challenges, particularly for critically ill neonates with low birth weight and younger gestational age. Several devices and techniques can be used to place a CVC, each with its own advantages and disadvantages. Ultrasound (US) guided central inserted central catheter (CICC) of the brachiocephalic vein (BCV) is a new approach that may be advantageous in case of difficult central venous access.</p><p><strong>Purpose: </strong>To evaluate the feasibility and outcomes of the supraclavicular US guided cannulation of the BCV in newborns.</p><p><strong>Method: </strong>Case series including all neonates in whom US-guided supraclavicular cannulation of the BCV was performed.</p><p><strong>Setting: </strong>This is a prospective, single-center study conducted in the neonatal intensive care unit in Sousse, Tunisia, between January 1, 2021, and December 31, 2023.</p><p><strong>Participants: </strong>Inclusion criteria were all neonates whose medical situation required ultrasound guided CICC placement of BCV. Exclusion criteria were thrombosis of the homolateral or contralateral brachiocephalic vein, skin infection or malformations at the homolateral brachiocephalic vein puncture site.</p><p><strong>Results: </strong>The study included 62 patients with a mean gestational age of 38.42 ± 2.2 weeks (34-42), mean weight of 3400 g ± 580 g (2500-4800 g). The procedure achieved a 96.7% success rate, with 80.4% of catheters successfully placed on the first attempt. The mean insertion depth of the catheter insertion was 6.4 cm ± 0.5 cm (5-7). Immediate complications were absent in 96% of cases, and catheters were accurately positioned in 80% of patients. The median catheters dwell time was 11.5 ± 8 days (1-42). Late complications included thrombosis 4.8% and CRBSI rate of 3.9 per 1000 catheter days.</p><p><strong>Conclusion: </strong>The real-time, in-plane, US-guided supraclavicular approach for BCV cannulation is a feasible and safe alternative for CVC in neonates.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251349037"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334483","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 effect of fistula education given to patients receiving hemodialysis treatment on their self-care behaviors.","authors":"Ozlem Ozdemir","doi":"10.1177/11297298251347711","DOIUrl":"https://doi.org/10.1177/11297298251347711","url":null,"abstract":"<p><strong>Introduction: </strong>Arteriovenous fistula is of vital importance for hemodialysis patients. Patients should provide fistula self-care to maintain fistula patency.</p><p><strong>Objective: </strong>This study was conducted to determine the effect of education given to hemodialysis patients regarding arteriovenous fistula on their self-care behaviors.</p><p><strong>Methods: </strong>The study with a pre- and post-test design and a control group was conducted with total of 70 patients. Data were collected using \"Self-Care Behavior Assessment Scale For Arteriovenous Fistula in Hemodialysis.\"</p><p><strong>Results: </strong>After the training, experimental group showed better overall self-care behaviors with AVF than control group (72.1% and 85.3%, respectively, <i>p</i> = 0.000) as well as better self-care concerning both the management of signs and symptoms (74.0% and 89.7% respectively, <i>p</i> = 0.000) and the prevention of complications (71.0% and 82.6%, respectively, <i>p</i> = 0.000).</p><p><strong>Conclusion: </strong>Education for patients was found to improve their fistula-related self-care behaviors. Patient education given with written materials will contribute to the prevention of fistula-related complications and the management of signs and symptoms.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251347711"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334482","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":"Comparative study of modified HeRO grafts using bovine carotid artery as conduits versus polytetrafluoreythylene.","authors":"Daniel Kong, Francisco Lim, Gabriel Jabbour, Emerito Asuncion, Farris Hakki, Jesse Garcia","doi":"10.1177/11297298251343332","DOIUrl":"https://doi.org/10.1177/11297298251343332","url":null,"abstract":"<p><strong>Objectives: </strong>Hemodialysis reliable outflow (HeRO) device is currently the only option for hemodialysis for catheter-dependent dialysis patients with central venous stenosis who are poor candidates of fistulas and grafts. The proprietary HeRO device is connected to a standard polytetrafluorethylene (PTFE) conduit. Previous studies have showed decreased rates of infection using bovine carotid artery graft (BCAG) compared to the PTFE graft for arteriovenous grafts (AVG). This is the first study to compare the use of BCAG to PTFE for HeRO grafts.</p><p><strong>Methods: </strong>From Jan 2015 to Dec 2022 we inserted 83 HeRO grafts on ESRD patients, 40 cases used the standard PTFE graft as the conduit connected to the HeRO component and 43 cases used the BCAG grafts. We did a 2 year follow up review on all the patients using the Kaplan Meier's survival analysis to compare the primary, primary-assisted patency and secondary patency, graft lifespan comparison, infection and complications.</p><p><strong>Results: </strong>PTFE was associated with significantly increased rates of infection compared to BCAG (40% vs 16.3%, <i>p</i> = 0.026). Comparing BCAG versus PTFE, primary patency was 58.4% versus 59% at 6 months (<i>p</i> = 0.82) and 34.9% versus 34.1% at 1 year (<i>p</i> = 0.88). Primary-assisted patency was 88.6% versus 80.6% at 6 months (<i>p</i> = 0.35) and 69.7% versus 54.6% at 1 year (<i>p</i> = 0.21). Secondary patency was 94.3% versus 85.7% (<i>p</i> = 0.23) at 6 months and 82.4% versus 59.1% at 1 year (<i>p</i> = 0.12).</p><p><strong>Conclusions: </strong>Bovine carotid artery grafts are comparable in primary patency, primary-assisted patency, and secondary patency versus PTFE. Number of interventions required and done were similar in both groups. BCAG was associated with lower rates of infection compared to PTFE. BCAG is an acceptable conduit for HeRO graft and may be a better option compared to PTFE.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251343332"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327882","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":"Complex reconstructive procedure for pseudoaneurysm in arteriovenous fistula: A clinical case.","authors":"Andrey Sorokin, Aleksei Filippov, Dmitriy Shmatov","doi":"10.1177/11297298251347092","DOIUrl":"https://doi.org/10.1177/11297298251347092","url":null,"abstract":"<p><p>Pseudoaneurysm formation at the site of arteriovenous fistula (AVF) poses a significant threat to vascular access patency in patients undergoing hemodialysis. Management of such complications is particularly challenging in patients with a history of multiple AVF failures. A 27-year-old patient with end-stage renal disease on maintenance hemodialysis for 2 years presented with a rapidly enlarging mass (5 × 5 × 4 cm) and local skin changes at the site of a previously created radial artery-basilic vein AVF. The patient had a history of multiple AVF thromboses and redo reconstructions. Duplex ultrasound confirmed a pseudoaneurysm involving the outflow vein on the forearm. Surgical management included excision of the outflow vein with the pseudoaneurysm, mobilization of collateral vein, creation of an end-to-end anastomosis between this vein and part of normal outflow vein and creation of an end-to-side anastomosis between the basilic vein and the brachial vein to ensure adequate outflow and minimize the risk of recurrent thrombosis. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. Dialysis via the reconstructed vascular access was resumed 2 months after surgery and has remained functional for over 18 months without complications or limitations. This case highlights the importance of individualized and complex surgical approaches for the management of AVF pseudoaneurysms. Timely and tailored interventions can preserve vascular access and maintain quality of life, even in patients with complex vascular histories.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251347092"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327883","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-based tip navigation and tip location during placement of central venous access devices in adult patients: The ECHOTIP protocol revisited.","authors":"Maria Giuseppina Annetta, Stefano Elli, Antonio Gidaro, Davide Giustivi, Emanuele Iacobone, Mauro Pittiruti","doi":"10.1177/11297298251347084","DOIUrl":"10.1177/11297298251347084","url":null,"abstract":"<p><p>Ultrasound has an important role in many aspects of central venous catheterization. In the last decade, bedside ultrasound has been regarded as a promising tool also for ensuring an accurate and intraprocedural assessment of the location of the catheter tip, as an alternative or complimentary option to intracavitary electrocardiography. In this regard, 5 years ago the Italian Group of Venous Access Devices (GAVeCeLT) developed detailed protocols for the standardization of this methodology in different populations of patients: neonates (Neo-ECHOTIP), children (ECHOTIP-Ped), and adults (ECHOTIP). In the lapse of time since the publication of these protocols, recent clinical studies have brought novel information and new evidence, so that some recommendations included in the original ECHOTIP protocol for adults today may seem incomplete or inappropriate. For this reason, GAVeCeLT has developed an updated version of the protocol, nick-named ECHOTIP-2, which includes new recommendations in regards of some technical aspects of the procedure of bubble test and of the application of the method to femorally inserted central catheters.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251347084"},"PeriodicalIF":1.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259449","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 missing pulse: Anatomical variation of the radial artery encountered during arterial cannulation.","authors":"Shikha Jain, Lokho Pfokreni, Vaishali Waindeskar, Abhinav Vijay","doi":"10.1177/11297298251345998","DOIUrl":"https://doi.org/10.1177/11297298251345998","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345998"},"PeriodicalIF":1.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251047","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":"Virtual reality and AVF pain: Promising results, but methodological caveats remain.","authors":"Taha Bhatti","doi":"10.1177/11297298251345515","DOIUrl":"https://doi.org/10.1177/11297298251345515","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345515"},"PeriodicalIF":1.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251048","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":"From prevention to treatment: Comprehensive strategies for the management of Staphylococcus aureus induced catheter-related bloodstream infections.","authors":"Salvatore Mandolfo, Stefano Possenti, Maria Antonia De Francesco, Bernardo Lucca, Arnaldo Caruso, Federico Alberici","doi":"10.1177/11297298251342301","DOIUrl":"https://doi.org/10.1177/11297298251342301","url":null,"abstract":"<p><p>Staphylococcus aureus (SA) is a prominent pathogen that frequently causes catheter-related bloodstream infections (CRBSIs) in hemodialysis patients with tunneled central lines. The guidelines' key recommendation for managing SA-induced CRBSIs is to remove the infected catheter. In real life, however, this may be hindered by logistical or clinical problems (e.g. unavailability of surgical rooms, incarcerated catheters, catheter-associated thrombosis). Furthermore, an interventional approach may expose patients to complications, such as those related to the procedure itself or the development of central vein stenoses. Prospective observational studies seem to support the possibility of preserving the infected line in case of early pathogen identification and CRBSI management with empirical large-spectrum antibiotics, followed by targeted treatment once the antibiogram is available. Further options for the treatment and prevention of SA-induced infections are becoming available, leading to a rapidly evolving therapeutic scenario. This review aims to perform a multidisciplinary revision of the available evidence and current unsolved problems, focusing on future perspectives for the management and prevention of SA-induced CRBSIs in hemodialysis patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342301"},"PeriodicalIF":1.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251046","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":"Comparison of aneurysmorrhaphy with and without external support for the management of arteriovenous aneurysms.","authors":"Peter Balaz, Slavomír Rokosny, Bretislav Fabian, Peter Wohlfhart, Adam Whitley","doi":"10.1177/11297298251345370","DOIUrl":"https://doi.org/10.1177/11297298251345370","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysm formation is a complication of the use of arteriovenous fistulas, and symptomatic aneurysms require surgical treatment. The optimum treatment is aneurysmorrhaphy, because this salvages the function of the fistula. Aneurysmorrhaphy outcomes may be improved by implanting an external prosthesis over the repaired aneurysm. This study aimed to compare aneurysmorrhaphy performed with and without an external prosthesis.</p><p><strong>Materials and methods: </strong>This was a multicenter, randomized, prospective non-blinded study. Patients with symptomatic aneurysms of arteriovenous fistulas were recruited between February 2018 and September 2022. Recruited patients were assigned randomly to undergoing aneurysmorrhaphy with or without an external prosthesis. The study compared patency and aneurysm recurrence rates at 1-year follow-up.</p><p><strong>Results: </strong>Forty-six patients underwent aneurysmorrhaphy with an external prosthesis and fifty-five underwent aneurysmorrhaphy without an external prosthesis. There were no differences in patient and aneurysm characteristics between the two groups. At 1 year follow-up, the patency rates were 86% for aneurysmorrhaphy with external prosthesis and 80% for aneurysmorrhaphy without external prosthesis (<i>p</i> = 0.87). Aneurysm recurrences occurred in 2 patients (4.3%) who underwent aneurysmorrhaphy with external prosthesis and in 6 patients (10.9%) who underwent aneurysmorrhaphy without external prosthesis (<i>p</i> = 0.114).</p><p><strong>Conclusion: </strong>There was no statistically significant difference in primary patency rates and aneurysm recurrence between patients treated with aneurysmorrhaphy with and without external prosthetic support.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345370"},"PeriodicalIF":1.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217689","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":"Venturi effect simulating stenosis in hemodialysis arteriovenous fistulas.","authors":"George Neves-Almeida, Edna Maria de Faria Viana, Marcos Rocha Vianna, Nathalia Sernizon Guimarães, Daniel Mendes-Pinto, André Alves Elias, Lívia Fagundes Dos Anjos Araújo, Maria da Glória Rodrigues-Machado","doi":"10.1177/11297298251345179","DOIUrl":"https://doi.org/10.1177/11297298251345179","url":null,"abstract":"<p><strong>Background: </strong>A collapse phenomenon associated with stenoses was observed during Doppler ultrasound (DUS) examinations in arteriovenous fistulas (AVFs).</p><p><strong>Aim: </strong>To investigate the influence of the phenomenon over the diagnosis of stenosis, its prevalence and cause.</p><p><strong>Method: </strong>Comparison of luminal diameters before and during downstream compression of the efferent vein (DCEV); retrospective cross-sectional analysis of the prevalence; and theoretical analysis based on cardiovascular physiology and flow mechanicals and analysis of pressure gradients.</p><p><strong>Results: </strong>DCEV increased the luminal diameter at the phenomenon sites from 1.64 ± 0.78 mm to 4.03 ± 1.42 mm (<i>p</i> < 0.0001). The prevalence of the phenomenon was 11.3% (25) between 221 different AVFs and 16.6% (25) between 150 AFVs with stenoses. Pressure gradients in systole (147.9 ± 67.15 mmHg) and diastole (66.74 ± 37.7 mmHg) indicated intraluminal low pressures at the phenomenon sites.</p><p><strong>Conclusions: </strong>The collapse phenomenon can simulate AVF stenoses ⩾50% in DUS examinations, have an important and high prevalence between AVFs with stenoses and is compatible with the Venturi effect.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345179"},"PeriodicalIF":1.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217690","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}