Journal of Vascular Access最新文献

{"title":"Retraction: Novel electrospun polyurethane grafts for vascular access in rats.","authors":"","doi":"10.1177/11297298251316657","DOIUrl":"https://doi.org/10.1177/11297298251316657","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251316657"},"PeriodicalIF":1.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257407","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":"Role of renal vascular coordinator on access flow dysfunction: A quality improvement initiative on improving patency rate.","authors":"Mary Lim Zhi Ting, Cathrine Kong May Ching, Chai Chung Cheen, Allen Liu Yan Lun","doi":"10.1177/11297298251316953","DOIUrl":"https://doi.org/10.1177/11297298251316953","url":null,"abstract":"<p><p>A renal vascular coordinator (RVC) is a single point-of-contact allied health professional in the early detection and timely intervention of flow dysfunction. In Khoo Teck Puat Hospital (KTPH), RVC performs access ultrasonography assessment and assists in reviewing direct referrals about dysfunctional arteriovenous fistula (AVF)/arteriovenous graft (AVG) from community dialysis centres and plans for appointments with interventional nephrologists and vascular surgeons. We conducted a prospective study from April 2020 to December 2022 to evaluate the appointment-to-intervention time (AIT) and patency rate (PR) of vascular access interventions. Secondary outcome was the percentage of vascular access loss. Ninety-three patients were referred to the RVC and were offered thrombectomy or angioplasty. Twenty-seven patients were excluded from the analysis (did not require intervention (9), admitted without RVC assessment (13), defaulted (4), or bypassed an RVC appointment to their first intervention (1)). The median time from referral to their first RVC visit was 4 (3-6) days. The median AIT for the RVC group was 6 (3-11) days (21.5% within 48 h). The median AIT for the non-RVC group was 6 (2.3-12.8) days (25.5% within 48 h, <i>p</i> = 1.0). The 6-month and 12-month post-intervention PR was 71% and 61.3%, respectively. Fifty-one of the remaining ninety-three patients had previous procedures done to their AVF before April 2020 without RVC involvement. The 6-month and 12-month post-intervention PR was 51% (<i>p</i> < 0.016) and 15.7% (<i>p</i> < 0.00001), respectively. The percentage of vascular access loss was similar in both RVC and non-RVC groups (4.3% vs 2%, <i>p</i> = 0.44). With the addition of RVC, vascular access outcome is improved with longer PR for up to 12 months, with no difference in AIT and number of vascular access losses.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251316953"},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191484","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":"Retained foreign body in radial artery: Endovascular retrieval and salvage of a hemodialysis arteriovenous fistula.","authors":"Chia Choon Kwang Adrian, Tay Hsien Tsung","doi":"10.1177/11297298251315986","DOIUrl":"https://doi.org/10.1177/11297298251315986","url":null,"abstract":"<p><p>A foreign body was inadvertently retained in the patient's radial artery during a previous endovascular procedure, leading to early recurrent thrombosis of his hemodialysis arteriovenous fistula. Through the strategic use of ultrasound, a through-and-through wire, as well as sequential balloon inflation to \"push\" the foreign body, it was successfully retrieved endovascularly, leading to effective salvage of the patient's hemodialysis access.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251315986"},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191468","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":"Feasibility and Safety of bedside placement of tunneled dialysis catheters: A systematic review and meta-analysis of prevalence.","authors":"Ayman Bsat, Moussa Hojeij, Bassel Hafez, Sami Nabhani, Marwan Bahmad, Yasmine Kotob, Rakan Nassereldine","doi":"10.1177/11297298251316951","DOIUrl":"https://doi.org/10.1177/11297298251316951","url":null,"abstract":"<p><p>Tunneled dialysis catheters (TDCs) are typically the vascular access of choice for critically ill patients in need of urgent dialysis for prolonged periods of time. The standard of practice is to insert these catheters under fluoroscopic guidance to ensure proper catheter placement in the cavo-atrial junction or right atrium. However, there is increasing interest in bedside placement of TDCs without fluoroscopic guidance in patients deemed too critically ill to be transported to the fluoroscopy suite or operating room. Our aim was to systematically review the literature on bedside placement of TDCs and to calculate the pooled prevalence rates of technical success, favorable clinical outcomes, and overall complications. We searched PubMed and Google Scholar for articles on bedside insertion of TDCs without setting a specific timeframe. We stratified the articles based on the risk of publication bias. Data on technical success, favorable clinical outcomes and complications were collected. A total of 22 articles were included, comprising 1546 TDCs inserted at bedside. The technical success rate was found to be 97.2% [95% CI: 94.6 - 98.9%; I2 = 77.5%]; LFK index = -0.72 and favorable clinical outcome was reported in 97.6% [95% CI: 94.5-99.5%; I2 = 84.8%]; LFK index = -1.62. The pooled prevalence of complications was found to be 6.98% [95% CI: 3.12 - 12.1%; I2 = 87.8%]; LFK index = 0.95, most of which were mechanical in nature. Our findings suggest that bedside placement of TDCs is a technically feasible procedure with high favorable clinical outcomes and comparable complication rates to the conventional method of TDC insertion under fluoroscopic guidance. Several non-fluoroscopic techniques have also been suggested to confirm the proper positioning of the catheter in the right atrium. These findings may challenge the gold standard of utilizing fluoroscopic guidance for TDCs.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251316951"},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191467","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 and fluoroscopy co-guided removal of extravascular stripped central line guidewire fragments.","authors":"Stuti Chandola, Priyanka Naranje","doi":"10.1177/11297298251315982","DOIUrl":"https://doi.org/10.1177/11297298251315982","url":null,"abstract":"<p><p>Inadvertent retention of guidewire is an infrequent but well recognized complication with central line insertion and other interventional procedures. The fragment can either embolize within the vascular system or get retained in soft tissues adjacent to the vein. Occasionally, the guidewire may be stripped owing to forceful pulling over the puncture needle during the procedure. Retention of such stripped guidewire fragments in soft tissues may remain undetected unless the wire is carefully inspected. While removal of the intravascular guidewire fragments via snare devices is well documented in literature, surgical removal of the fragments lodged in soft tissues may not always be feasible owing to the close proximity to vascular structures or may require extensive exploration for deep-seated fragments, which necessitates using general anesthesia in the pediatric population. Image guided removal may be utilized as a useful alternative for overcoming such issues. We report a case of image guided removal of stripped femoral central line fragments embedded in the soft tissue in a pediatric patient.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251315982"},"PeriodicalIF":1.6,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191486","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":"Metastasis of an urothelial carcinoma as rare cause of an AV-graft dysfunction in a transgender patient.","authors":"Abdalla Marei, Martin Hohls, Aristotelis Touloumtzidis, Marcus Katoh, Gabor Gäbel","doi":"10.1177/11297298251313620","DOIUrl":"https://doi.org/10.1177/11297298251313620","url":null,"abstract":"<p><p>A 66-year-old transfeminine patient presented to our institution with a central-venous stenosis causing dysfunction of her arteriovenous (AV) graft on her left arm. The patient was treated repeatedly, because of restenosis. Due to complete occlusion of the graft and subclavian vein as well as a liquid tumor located around the stenotic segment of the vein, we resected the left subclavian vein via a trap-door thoracotomy and inserted a PTFE-graft. Histological examination of the resected tissue identified metastasis from the urothelial carcinoma as the underlying cause of the stenosis. Malignant tumors are an infrequent etiology of AV-access dysfunction, and there are hardly any data on transgender patients. This case report provides an overview of the current data concerning these unique circumstances.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251313620"},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069984","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":"A risk prediction model for adult patients with difficult intravenous access.","authors":"Yijun Ji, Chang Liu, Xiuzhu Cao, Linfang Zhao","doi":"10.1177/11297298251314909","DOIUrl":"https://doi.org/10.1177/11297298251314909","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The challenges posed by difficult intravenous access (DIVA) in clinical treatment are not only related to technical difficulties but also have the potential to affect the quality of patient care and overall experience. It is crucial to adopt effective strategies to address difficult intravenous access. Currently, the assessment of difficult veins largely relies on individual perception and experience, which introduces a significant degree of subjectivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To develop and validate a risk prediction model for DIVA in adult patients, providing a tool for early identification and intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;An observational study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective data collection was conducted on 1170 hospitalized patients who required the placement of a short peripheral venous catheter for treatment in a tertiary hospital from June 1, 2022, to September 30, 2022, as the training set. Logistic regression analysis was employed to identify factors influencing DIVA in adult patients and to construct a risk prediction model. Prospective data collection was conducted on 300 hospitalized patients from June 1, 2023, to June 30, 2023, for external validation. The discriminative ability, calibration, and clinical utility of the model were evaluated using the area under the receiver operating characteristic curve, calibration curve, and clinical decision curve, respectively. A TRIPOD checklist was used to guide the reporting of this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average age of patients in the training set was 58.60 ± 15.39 years. Among them, 626 were males (53.50%) and 544 were females (46.50%). The external validation group included a total of 300 patients with a mean age of 58.77 ± 15.26 years. There were 142 males (47.33%) and 158 females (52.67%). Advanced age, female sex, extreme weight (BMI &lt;18.5 or &gt;30), history of hemodialysis, axillary lymph node dissection for breast cancer, compromised skin integrity, history of DIVA, and target cannula size ⩽20G are independent predictive factors for DIVA in adult patients (all &lt;i&gt;p&lt;/i&gt; &lt; 0.05). The risk prediction model constructed based on these factors had an area under the ROC curve of 0.912 (95% CI 0.880-0.943) in the modeling group. The areas under the ROC curve in the internal and external validation groups were 0.887 (95% CI 0.855-0.924) and 0.870 (95% CI 0.799-0.942), respectively. Calibration curves showed good agreement between predicted and observed probabilities. Decision curve analysis demonstrated that intervening when the risk of venous puncture difficulty ranged from 3% to 91% yielded favorable clinical benefits for patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Constructing a risk prediction model for DIVA in adult patients has significant predictive value. It assists medical staff in early intervention and management for high-risk patients, thereby achieving effective prediction, warning, and contro","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251314909"},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069980","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":"Information needs in vascular access decision-making: A qualitative study of patient and clinical stakeholder perspectives.","authors":"Karen Stevenson, Ramsay Meiklem, Matt-Mouley Bouamrane, Peter Thomson, Mark Dunlop, Laura Martin, Catrin Jones, David Kingsmore","doi":"10.1177/11297298251314792","DOIUrl":"https://doi.org/10.1177/11297298251314792","url":null,"abstract":"<p><strong>Background: </strong>The information and decision support needs required to embed a patient-centred strategy are challenging, as several haemodialysis vascular access strategies are possible with significant differences in short- and long-term outcomes of potential treatment options. We aimed to explore and describe stakeholder perspectives on information needs when making decisions about vascular access (VA) for haemodialysis.</p><p><strong>Methods: </strong>We performed thematic analysis of seven (six online, one in person) focus group discussions including transcripts, post-it phrases and text responses with 14 patients and 12 vascular access professionals (four nephrologists, three surgeons and five nurses - Vascular access nurse specialists/Education and dialysis nurses) who participated in at total of six online and one in person focus group.</p><p><strong>Results: </strong>All patients had experience of haemodialysis and 50% had experience with at least one other modality of RRT. Ten patients had experience of more than one VA modality and 4/14 had experience of AVG, 13/14 had experience of AVF and 8/14 had experience of TCVC. We identified four semantic themes and two latent themes. The themes and their subthemes reflected information needs of patients when making vascular access decisions: Knowledge, Risks and Benefits of Relevant options, long-term treatment strategy and Personal Impact of VA. The latent themes, identified across all stakeholders, were of the need for consistent and trustworthy information.</p><p><strong>Discussion: </strong>All recent vascular access guidelines propose a shared decision-making approach to vascular access. The ability to implement this in practice carries an information need for both patients and clinicians. This study describes a framework model which can be applied during co-design and assessment of vascular access educational resources to facilitate a patient centred perspective.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251314792"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061507","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":"Assessment of safety and effectiveness after percutaneous closure for decannulation of Veno-Arterial Extracorporeal Membrane Oxygenation: A systematic review and meta-analysis.","authors":"Tomás Marques Pereira, Diana Martins-Fernandes, Ana Rita Ferreira, Henrique Guedes da Rocha, Mario D'Oria, João Rocha-Neves","doi":"10.1177/11297298241312753","DOIUrl":"https://doi.org/10.1177/11297298241312753","url":null,"abstract":"<p><strong>Introduction: </strong>Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) has emerged as a crucial component of critical care medicine, mainly as a lifesaving intervention for patients experiencing refractory cardiac arrest and respiratory failure.</p><p><strong>Background: </strong>In the past, VA-ECMO decannulation was surgical and often associated with a high rate of periprocedural complications, such as surgical site infection, bleeding, and patient mobilization costs. To reduce the rate of these adverse events, many percutaneous techniques utilizing suture-mediated closing devices have been adopted. One of those devices is the Perclose Proglide^® (PP).</p><p><strong>Objective: </strong>This study's goal was to perform a systematic review to evaluate PP devices' success and complication rates for VA-ECMO decannulation.</p><p><strong>Methods: </strong>To analyze the outcomes of PP in VA-ECMO decannulation, a systematic review of the most recent literature was conducted. The Medline, Web of Science, and Cochrane databases were systematically searched up to September 2023. The National Health, Blood, and Lung Institute Study quality assessment tools were used.</p><p><strong>Results: </strong>The final analysis included 10 observational studies comprising 418 patients. The efficacy of PP in VA-ECMO decannulation was 93.0% (95% CI 90.1%-96.0%). In 381 patients, the incidence of acute limb ischemia after VA-ECMO decannulation was 2.5% (95% CI 0.9%-4.%), the infection of the puncture site after decannulation was 1% (95% CI 0%-2%) in 385 patients. The incidence of patients with pseudoaneurysm after decannulation was 1.1% (95% CI 0.1%-2.1%).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis demonstrate the safety and efficacy of the PP for achieving hemostasis after VA-ECMO decannulation, with a high success rate and low rate of major complications.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298241312753"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061541","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":"Factors associated with early and late losses of primary patency following drug-coated balloon for dysfunctional arteriovenous fistula.","authors":"Kotaro Suemitsu, Osamu Iida, Kazuhiro Sato, Masahito Miyamoto, Masaaki Murakami, Taku Toyoshima, Masaaki Izumi","doi":"10.1177/11297298251314065","DOIUrl":"https://doi.org/10.1177/11297298251314065","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a drug-coated balloon (DCB) for the treatment of dysfunctional arteriovenous fistulas (AVFs) and to identify the risk factors associated with early and late losses of primary patency following DCB in real-world practice.</p><p><strong>Methods: </strong>This multicenter, retrospective study included 407 patients (72 ± 11 years, 64.1% males) with dysfunctional AVFs (juxta-anastomotic lesion location in 58.7% of cases, mean size 1.2 mm, mean length 54 mm) who underwent DCB for the first time for the treatment of dysfunctional AVF. The primary outcome measure was the loss of primary patency after DCB. The secondary outcome measures were the factors associated with early (<90 days) and late (⩾90 days) losses of primary patency after DCB.</p><p><strong>Results: </strong>The primary patency rates 6 and 12 months after DCB were 72.5% ± 2.3% and 40.1% ± 2.7%, respectively. The factors associated with the early loss of primary patency were de novo lesions (adjusted hazard ratio [HR], 7.91; [95% confidence interval (CI), 1.90-32.97]; <i>p</i> = 0.005), endovascular treatment (EVT) history within the previous 90 days (adjusted HR, 9.29; [95% CI, 3.09-27.92]; <i>p</i> < 0.001) and juxta-anastomotic stenosis (adjusted HR, 0.30; [95% CI, 0.13-0.70]; <i>p</i> = 0.005). The factors associated with a late loss of primary patency included EVT history within the previous 90 days (adjusted HR, 2.52; [95% CI, 1.89-3.38]; <i>p</i> < 0.001) and pre-dilation balloon size (adjusted HR, 1.99; [95% CI, 1.50-2.64]; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>DCB is an effective device to prolong the patency of dysfunctional AVFs in most cases. De novo lesions and their locations were associated with an early loss of primary patency, whereas the vessel preparation balloon size was associated with a late loss of primary patency. EVT history within the previous 90 days was associated with early and late losses of primary patency.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251314065"},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061487","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}