Journal of Vascular Access最新文献

{"title":"Histopathologic findings of proliferative and chronic neointimal lesions after stent graft placement in arteriovenous grafts.","authors":"Hidehiko Taguchi, Kotaro Suemitsu, Koji Masumoto, Amane Yamauchi, Hiroshi Okada, Minoru Ichikawa","doi":"10.1177/11297298251381130","DOIUrl":"https://doi.org/10.1177/11297298251381130","url":null,"abstract":"<p><p>Stent grafts (SGs) are designed to prevent neointimal ingrowth via their expanded polytetrafluoroethylene lining, but restenosis within the stent lumen has been observed in some cases. Here, we report on intra-SG and distal edge stenoses that developed in three patients after SG placement for arteriovenous graft venous anastomotic stenosis. Histopathologic evaluation of the stenoses revealed fibrotic intimal thickening. The intra-SG lesions showed either α-smooth muscle actin-positive spindle cells or chronic fibrotic tissue with hyalinization, and the analyzed distal edge lesion showed α-SMA-positive and partially desmin-positive cells, suggesting myogenic differentiation. To our knowledge, this is the first report to histopathologically confirm intimal tissue formation within the SG lumen. These findings provide histopathologic insight into the spectrum of SG-associated restenosis and suggest that drug-coated balloons, which target intimal hyperplasia, may have therapeutic potential for both intra-SG and distal edge stenoses.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251381130"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246090","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 edema severity on basilic and superficial femoral vein diameters: Implications for peripherally inserted central catheter placement in critically ill patients.","authors":"Ying-Hung Tang, Tzu-Chun Wang, Kuang-Hua Cheng, Kuan-Pen Yu","doi":"10.1177/11297298251383737","DOIUrl":"https://doi.org/10.1177/11297298251383737","url":null,"abstract":"<p><strong>Background: </strong>Edema in critically ill patients poses challenges for vascular access, particularly during peripherally inserted central catheter (PICC) placement. The cross-sectional area of veins significantly influences catheterization success and complication rates.</p><p><strong>Objective: </strong>This study investigates the relationship between edema severity and the diameters of the basilic vein and superficial femoral vein (mid-thigh level) to optimize vascular access strategies.</p><p><strong>Material and methods: </strong>A retrospective analysis of 11 intensive care unit (ICU) patients from a tertiary medical center in Taiwan was conducted, using medical records collected between August 2023 and May 2024. The study examined the association between ultrasound-graded edema severity and venous diameters. A random-effects linear panel data regression model was applied to assess the relationship, with statistical significance defined as <i>p</i> < .05.</p><p><strong>Results: </strong>Increasing edema severity was significantly associated with a reduction in basilic vein diameter (<i>p</i> < .001), while no significant changes were observed in the superficial femoral vein (<i>p</i> = .44). Adjustments for confounders did not alter these findings. The basilic vein exhibited a linear trend decrease of -0.7 mm per edema grade, while the femoral vein remained relatively unaffected.</p><p><strong>Conclusion: </strong>Edema significantly narrows the basilic vein but spares the superficial femoral vein; if further swelling is anticipated, avoid basilic PICC placement and instead use the superficial femoral vein, of which the diameter remains comparatively stable.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251383737"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246047","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":"Preclinical testing of acellular and polyphenol-stabilized arterial xenografts in sheep.","authors":"Marius M Harpa, Emanuel D Anitei, Dan T Simionescu, Alexandra I Puscas, Raluca I Truta, Ionela Cotfas, Hamida Al-Hussein, Tudor Capilna, Joshua G Wingold, Juan C C Garcia, Horatiu Suciu, Hussam Al-Hussein","doi":"10.1177/11297298251382538","DOIUrl":"https://doi.org/10.1177/11297298251382538","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is a global leading cause of death, prompting coronary heart diseases and peripheral artery diseases due to atherosclerotic artery narrowing. Currently, the most used vascular grafts are autologous arteries and veins. While considered the gold standard for small-diameter vascular replacements (<6 mm), these autologous vessels have limitations, including the need for invasive harvesting and unsuitability for some patients. Tissue-engineered vascular grafts have become a possible treatment in future cardio-vascular graft surgery. These grafts are designed to incorporate living cells, allowing for physiological remodeling.</p><p><strong>Methods: </strong>Cell-free porcine vascular xenografts were implanted surgically into the left carotid arteries of seven recipient sheep, and the subsequent inflammatory and clinical responses were monitored over the following 12 weeks. All seven sheep were euthanized humanely after that period, and a histological examination of the implant site was carried out.</p><p><strong>Results: </strong>Results showed that endothelial cells had colonized the luminal surface of the cell-free scaffold, and evidence of calcification associated with the transplant site was absent. This indicates that the material is biocompatible and capable of being repopulated. In two recipients, thrombus occlusions formed.</p><p><strong>Conclusions: </strong>We conclude that using a three-dimensional cell-free porous arterial grafting technique may have the potential for in vivo host cellular repopulation in arterial graft surgical treatments.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251382538"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253853","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":"Performance and safety of Femorally Inserted Central Catheters in oncological patients: A cases series analysis.","authors":"María Teresa Parejo Arrondo, Berta Griso Jurado, Lourdes Bayona Escat, Gloria Ortiz-Miluy, Inmaculada C Grau Farrús, Josep Gumà","doi":"10.1177/11297298251375510","DOIUrl":"https://doi.org/10.1177/11297298251375510","url":null,"abstract":"<p><strong>Background: </strong>Selection of vascular access devices (VADs) is critical for successful intravenous therapy, especially in oncology patients requiring long-term central VADs. In cases where upper-body venous access is not viable, femoral access has traditionally been avoided due to higher infection and thrombosis risks. However, new protocols and technologies have redefined the safety and feasibility of femorally inserted central catheters (FICCs).</p><p><strong>Objective: </strong>This study evaluates the outcomes of FICC insertions in oncology patients at a tertiary hospital in Spain, using advanced techniques including ultrasound-guided insertion, tunneling, and tip confirmation.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in 2025 with 25 cancer patients who required elective central DAVs and lacked viable upper-body veins between November 2021 and June 2024. All procedures were performed by an experienced vascular access nurse, following the RaFeVA and SIF protocols. Data on demographics, catheter type, vein selection, complications, and dwell time were collected and analyzed.</p><p><strong>Results: </strong>A total of 25 FICCs were inserted. The superficial femoral vein was used in 84% of cases. No catheter-related bloodstream infections (CRBSIs) or symptomatic thromboses were reported. Mean dwell time varied according to treatment duration and patient survival, with several catheters remaining functional at data cutoff. Ultrasound-guided tip confirmation ensured proper positioning in the inferior vena cava.</p><p><strong>Conclusion: </strong>When inserted using modern protocols and technologies, FICCs offer a safe and effective alternative for oncology patients without viable upper-body venous access. This approach minimizes complications and enables timely catheter placement, supporting the broader adoption of lower-body central access in specific patient populations.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251375510"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246132","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":"Response to letter regarding 'Patient-related factors influencing the choice of haemodialysis access in Sweden'.","authors":"Emelie Laveborn, Michael Ott","doi":"10.1177/11297298251382875","DOIUrl":"https://doi.org/10.1177/11297298251382875","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251382875"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246140","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":"Surgical revision to salvage degeneration of hemodialysis access is effective but is associated with a high burden of reinterventions.","authors":"Zachary A Matthay, Gabriella A Camacho, Alexandra Sansosti, Joshua Herbert, Sean Kalloo, Thomas F X O'Donnell, Virendra I Patel, Nicholas J Morrissey","doi":"10.1177/11297298251382876","DOIUrl":"https://doi.org/10.1177/11297298251382876","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal degeneration and ulceration of arteriovenous access (AV-access) for hemodialysis is a morbid and potentially lethal scenario. Outcomes of surgical revision to salvage failing AV-access versus ligation followed by new access creation are not well described. We hypothesized that surgical revision would be associated with reduced tunneled dialysis catheter use but increased reinterventions.</p><p><strong>Methods: </strong>This single center retrospective study included all adult patients with aneurysmal, ulcerated, or bleeding AV-accesses undergoing surgical revision or ligation (2020-2023). Univariate statistics and Kaplan-Meier analysis compared characteristics and outcomes across groups. The decision to salvage versus ligate AV-access was based on the clinical judgment of the treating surgeon.</p><p><strong>Results: </strong>The cohort of 89 patients had a median age of 61 years and expected high rates of comorbidities which were not different between groups, including diabetes (45%), coronary artery disease (40%), and heart failure (37%). Of the 89 patients included, 15 had AV grafts and 74 had AV fistulas. The indications for intervention included aneurysmal degeneration alone (<i>n</i> = 39), ulceration (<i>n</i> = 24), and ulceration with bleeding (<i>n</i> = 26). Underlying aneurysmal degeneration was present in 72% of patients with ulceration and bleeding. Surgical revision to salvage AV-access was associated with reduced dialysis catheter use compared to ligation-44% after revision compared to 81% after ligation (<i>p</i> < 0.01) and fewer overall postoperative days with a dialysis catheter after surgery (<i>p</i> < 0.02). Reinterventions were more common after open revision versus ligation (58% vs 32%, <i>p</i> = 0.03), but only 5 patients (10%) in the open revision group required placement of a new surgical access during the follow up period.</p><p><strong>Conclusions: </strong>Despite a high rate of reinterventions, patients who underwent an open revision to salvage their av-access had significantly reduced dialysis catheter utilization and few required new surgical access creations. AV-access salvage should be considered for failing AV-access whenever possible to mitigate dialysis catheter-associated complications.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251382876"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246117","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":"Central venous access devices: Retrospective study of the implementation of a nursing led vascular access team and evaluation of complication rates.","authors":"Shori Gerardot, Matthew Pope-Filos, Bronte Yono, Kamal Patel, Bryan Roberts, Sangeetha Nanthabalan","doi":"10.1177/11297298251376977","DOIUrl":"https://doi.org/10.1177/11297298251376977","url":null,"abstract":"<p><strong>Introduction: </strong>Physicians have historically performed insertions of Central Venous Access Devices (CVADs). The ability to successfully place CVADs has increased with the implementation of ultrasound techniques to include safer placement and lower complications. The implementation of nursing lead vascular access teams (VATs) has become popular in hospitals for securing and maintaining access. This study aims to review a nursing lead team placing CVADs in comparison to physicians.</p><p><strong>Methods: </strong>The study was a retrospective single center study. Utilizing the VAT nurse procedure logs from 01/01/2019 to 06/30/2021, evaluation using chart review was performed to assess for: performing team, location of access, and any complications during and after the placement of central access. The data was stored on REDCAP data analysis tool without any protected health identification. After all the data was collected, it was sent for statistical analysis.</p><p><strong>Results: </strong>In this study, the primary outcome was an evaluation for difference in immediate complications between the physician and VAT group in insertion of CVADs. Analysis of 395 procedures for complications, including both Femoral (82) and Jugular (313) CVADs were evaluated based on the inserting team, physician (131) and VAT staff (264). The procedures were compared for immediate and delayed complications.</p><p><strong>Discussion: </strong>The complication rates and success rates were similar in both groups. Despite the study lacking enough power to be statistically significant, the outcomes of this study are promising, introducing new pathways for vascular access to accommodate both non-critically and critically ill patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251376977"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245971","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":"Response to: \"Patient-related factors influencing the choice of haemodialysis access in Sweden\".","authors":"Reshabh Yadav, Marc R M Scheltinga","doi":"10.1177/11297298251379382","DOIUrl":"https://doi.org/10.1177/11297298251379382","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251379382"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246053","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":"Effect of preoperative prolonged occlusion flow-mediated dilation on radial artery cannulation: A prospective randomized controlled trail.","authors":"Li Huang, Shishi Huang, Xian Chen, Siyin Fu, Yao Lin, Fei Yang, Xiaozhi Wu","doi":"10.1177/11297298251382527","DOIUrl":"https://doi.org/10.1177/11297298251382527","url":null,"abstract":"<p><strong>Background: </strong>Radial artery catheterization is commonly used for continuous blood pressure monitoring, arterial blood gas analysis, and routine blood sampling during the perioperative period. However, the small diameter of the radial artery and potential complications make catheterization challenging. This study was aimed to investigate the efficacy and safety of preoperative prolonged occlusion flow-mediated dilation (PO-FMD) in enhancing radial artery catheterization.</p><p><strong>Methods: </strong>A total of 144 patients scheduled for elective surgery requiring radial artery catheterization were enrolled in this study. Patients were randomly assigned to either the PO-FMD group or the sham PO-FMD group. For patients in PO-FMD group, the blood pressure was first measured, then inflated cuffs to 50 mmHg above the patients' systolic pressure and maintained for 5 min to induce radial artery dilation. The same procedure was performed for the sham PO-FMD group, except that the cuff was not inflated. Use an ultrasound machine to measure the diameter and depth of the radial artery at baseline, 5 min after the cuff was placed, and after catheter placement. The successful rate, numbers of attempt, durations, and complications of the cannulation were recorded.</p><p><strong>Results: </strong>One hundred and thirty-one patients completed the trial and were included in final statistical analysis. The PO-FMD group showed a significant increase in radial artery diameter compared to sham PO-FMD group and baseline. After catheterization, this diameter remained stable in the PO-FMD group but decreased in the sham PO-FMD group. No significant differences in radial artery depth were observed between groups. Then, the first-attempt success rate for radial artery cannulation was 86% in the PO-FMD group, significantly higher than the 64% success rate in the sham PO-FMD group. In the PO-FMD group, both the duration of cannulation and the number of attempts were lower compared to the sham PO-FMD group. Additionally, complications related to radial artery cannulation, such as arterial spasm, loss of pulsation and occlusion, occurred less frequently in the PO-FMD group than in the sham PO-FMD group.</p><p><strong>Conclusions: </strong>Our data suggested that the PO-FMD significantly increased and stabilized the radial artery diameter, improved the success rates of radial artery cannulation, shortens the time to successful catheterization, and decreases the incidence of cannulation-related complications.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251382527"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246026","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":"Validity and reliability study of the Turkish version of the Questionnaire on Best Practices for Short Peripheral Intravenous Catheter Maintenance: A methodological study.","authors":"Hediye Özbay, Seher Çevik Aktura","doi":"10.1177/11297298251381133","DOIUrl":"https://doi.org/10.1177/11297298251381133","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the validity and reliability of the Turkish version of the Questionnaire on Best Practices for Short Peripheral Intravenous Catheter Maintenance.</p><p><strong>Methods: </strong>A methodological design was employed between February and May 2025, involving a sample of 276 nurses. Participants were drawn from emergency departments, internal medicine units, surgical wards, and intensive care units across hospitals in two provinces in eastern Turkey. Data were collected using two instruments: the Nurses' Information Form and the Questionnaire on Best Practices for Short Peripheral Intravenous Catheter Maintenance. Descriptive statistics, including frequencies, percentages, means, standard deviations, medians, and minimum and maximum values, were used to describe participant characteristics. Content validity was assessed through expert review, and the Content Validity Index was calculated using the Davis technique. Item discrimination and difficulty indices were computed using Microsoft Excel. Reliability analysis involved calculation of the Kuder-Richardson Formula 20 (KR-20) coefficient, alongside item-total score correlation analysis.</p><p><strong>Results: </strong>The KR-20 coefficient for the Questionnaire on Best Practices for Short Peripheral Intravenous Catheter Maintenance was 0.974. Analysis of the test mean scores revealed that the items were generally easy but exhibited high discriminatory power.</p><p><strong>Conclusion: </strong>The Turkish version of the Questionnaire on Best Practices for Short Peripheral Intravenous Catheter Maintenance demonstrated high reliability, as evidenced by its KR-20 value. The use of this questionnaire enables the identification of knowledge gaps among nursing professionals regarding best practices in short peripheral catheter care.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251381133"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246119","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}