Journal of Vascular Access最新文献

{"title":"The NAVIGATE project: A GloVANet-WoCoVA position statement on the nomenclature for vascular access devices.","authors":"Matheus Roland van Rens, Robin van der Lee, Timothy R Spencer, Ton van Boxtel, Giovanni Barone, Alessandro Crocoli, Fulvio Pinelli, Mauro Pittiruti","doi":"10.1177/11297298241291248","DOIUrl":"10.1177/11297298241291248","url":null,"abstract":"<p><p>The field of vascular access has witnessed significant advancements in recent years, improving healthcare delivery across various patient populations through the use of diverse intravascular access devices. Despite these innovations, a critical issue remains: the lack of a globally standardized set of descriptors for these devices. This gap impedes clear communication and coordination within the healthcare community. Recognizing the necessity for standardized terminology, the Global Vascular Access Network (GloVANet), in collaboration with the World Congress of Vascular Access (WoCoVA), initiated the NAVIGATE project (<b>N</b>omencl<b>A</b>ture <b>V</b>ia <b>I</b>ntegrated <b>G</b>lobal <b>A</b>dvancements in <b>T</b>erminology <b>E</b>fficiencies). The aim of the project is to propose a clear and practical nomenclature for current vascular access devices, encompassing both central, peripheral venous, and arterial access devices. A panel of international vascular access experts from several clinical domains was selected by the Scientific Committee of WoCoVA to develop a position statement around vascular access device nomenclature. Following a comprehensive literature review, a consensus was reached using a modified Delphi process. The outcome of this collaborative effort is a WoCoVA/GloVANet position statement, which provides standardized nomenclature for vascular access devices. The adoption of unified terminology brings several benefits, firstly, it ensures clarity, reproducibility, and comparability when reporting in clinical studies, and secondly, reduces ambiguous or imprecise terms in communication between healthcare professionals in clinical practice.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1439-1446"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513627","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 aspirin on the outcome of upper limb AVF placement in hemodialysis patients: Discontinuation or not.","authors":"Behzad Azimi, Mohammad Mozaffar, Sina Soleimani, Behnaz Mousavi, Alireza Haghbin Toutounchi","doi":"10.1177/11297298241301527","DOIUrl":"10.1177/11297298241301527","url":null,"abstract":"<p><strong>Background: </strong>There is limited research on the consumption of aspirin and its effects on bleeding during arteriovenous fistula (AVF) placement surgery and associated complications in end-stage renal disease (ESRD) patients. Regarding the potential risks imposed on cardiac patients by discontinuing aspirin, the aim of the study was to determine whether aspirin should be discontinued prior to AVF placement surgery.</p><p><strong>Methods: </strong>This prospective study was carried out at two referral medical centers from 2023 to 2024. The patients were included as 30 patients who routinely took 80 mg of aspirin daily and 30 patients who did not take aspirin. The primary outcomes included the amount of blood loss, and the secondary outcomes included AVF success and maturation time. The amount of bleeding was assessed by the ΔHb (Hb₁-Hb₂), ΔHCT (HCT₁-HCT₂), and intraoperative hemorrhage volume.</p><p><strong>Results: </strong>Aspirin consumption did not significantly affect any of the examined parameters, including operation duration, hemoglobin decrease, hematocrit decrease, intraoperative hemorrhage, AVF success rate, maturity time, need for blood transfusion, postoperative bleeding, hematoma and thrombosis, hospitalization, and re-Operation (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>Aspirin did not have any significant or negative effects across any of the parameters examined. Based on the findings of this study, there is no need to discontinue aspirin in patients prior to upper limb AVF placement surgery, but further studies are recommended.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1704-1708"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775010","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":"Bedside 3D ultrasound fistula maturation assessment by non-expert sonographers provides equivalent accuracy to formal duplex sonography: A prospective clinical trial.","authors":"Lannery Lauvao, Jason Burgess, Devin O'Brien-Coon, Tyson Rogers, Alex Yevzlin, Jason Beaver","doi":"10.1177/11297298241287609","DOIUrl":"10.1177/11297298241287609","url":null,"abstract":"<p><strong>Background: </strong>EchoSure is an automated point-of-care 3D ultrasound (3DUS) designed to be used by dialysis technicians without advanced ultrasound training. The EchoMark/EchoSure System is a two-part system comprised of a bioresorbable implant, EchoMark, and a diagnostic ultrasound imaging platform, EchoSure. EchoSure was designed to enable any healthcare personnel in a dialysis clinic setting to obtain non-invasive, direct measurements of flow and vessel parameters that are critical quantifications used in the assessment of AVF maturation and readiness for hemodialysis cannulation.</p><p><strong>Objective: </strong>In this pilot feasibility study, we sought to explore whether use of an automated 3DUS could enable fistula assessment by non-experts and obtain measurement accuracy comparable to expert sonographer Duplex.</p><p><strong>Method: </strong>This was a 20 subject prospective multicenter trial conducted at four sites in the United States. All subjects had an EchoMark implanted under their AVF during the fistula creation procedure. Subjects were evaluated at 2-weeks post-op with EchoSure and Duplex, followed by monthly assessments until either the 4-month visit or until radiographic maturation was achieved, whichever was longer. Beyond monthly ultrasound assessments, clinical follow-up continued every 6 months between months 6 and 24.</p><p><strong>Result: </strong>Technical success of EchoMark implantation was demonstrated in 100% of subjects. Technical success of EchoSure was 99% across all scans. The mean percent difference in flow rate measurements between EchoSure and Duplex was -9.2% with a standard deviation of 38.1% compared to a mean percent difference of -15.7% with a standard deviation of 35.5% between Duplex measurements taken at the cannulation zone and brachial artery. Pearson correlation between EchoSure and Duplex was 0.708 versus 0.716 for the two Duplex measurements. Radiographic maturation was achieved in 70% of study subjects by 30 days and continued to rise to 90% through 90 days and 95% through 180 days after baseline.</p><p><strong>Conclusion: </strong>This study demonstrates the feasibility and accuracy of an automated 3D ultrasound system for assessment of maturation at the dialysis bedside by non sonographers.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1520-1530"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382494","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":"Safety and complications associated with tunneling and pseudotunneling techniques during PICC and Midline insertion.","authors":"Stefano Elli, Silvia Cavalli, Valentina Fantini, Marco Fragapane, Nicola Salvoldi, Paolo Zappa, Daniela Zedde, Sabrina Impaziente, Dario D'Amata","doi":"10.1177/11297298241292218","DOIUrl":"10.1177/11297298241292218","url":null,"abstract":"<p><strong>Introduction: </strong>Peripherally Inserted Central Catheters and Midline Catheters are particularly attractive because of their favorable risk/benefit ratio. If the ideal venipuncture site is in an area inappropriate for catheter emergence, a valid alternative is the tunneling technique, which allows the exit site to be moved to reach the optimal position. There are two main types of tunneling techniques: standard tunnel, using a tunneling device (metal tunneler or peel-away tunneler), and pseudo-tunnel. As much as both are recognized as appropriate and safe, there are still few literature data indicating the criteria for choosing and using the two techniques and the possible related complications.</p><p><strong>Methods: </strong>This retrospective observational investigation analyzed data regarding intra- and post-procedural complications of tunneled catheters inserted using two different techniques. The sample was stratified into three subgroups: (1) Standard Tunnel (patients with no PLT or INR disorders), (2) Pseudotunnel (patients with no PLT or INR disorders), and (3) Pseudotunnel (patients with any PLT or INR disorder). Data regarding the procedure, at 24 h and 7 days were collected and analyzed.</p><p><strong>Results: </strong>A total of 143 patients who underwent tunneled catheter insertion were included in the study. Among these, 113 patients were divided into subgroups 1 and 2 and 30 were assigned to subgroup 3. No significant differences were found among the three subgroups regarding immediate, short, and medium-term tunnel complications.</p><p><strong>Conclusions: </strong>The findings of this study suggest that both standard and pseudo-tunnels provide comparable levels of safety and comfort for patients. It was noted that Pseudotunnel offers an equivalent level of safety for patients with coagulation disorders related to PLT and INR, rendering it comparable to a \"minimally invasive procedure,\" which necessitates the same precautions as a non-tunneled PICC.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1582-1587"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513625","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":"Interventional nephrology in peritoneal dialysis: Best practice report of the Peritoneal Dialysis Project Group of the Italian Society of Nephrology.","authors":"Stefano Santarelli, Valentina Ramazzotti, Rosa Maria Agostinelli, Giorgio Degano","doi":"10.1177/11297298241258800","DOIUrl":"10.1177/11297298241258800","url":null,"abstract":"<p><p>The procedure of peritoneal dialysis (PD) catheter placement is of utmost importance for a good outcome of peritoneal dialysis. Currently, catheters are mainly placed by surgeons and interventional nephrologists. Still, there is a lack of trained personnel in many dialysis units, which can impair the efficiency of PD units and reduce the patients' possibility to enter a PD programme. The Italian Society of Nephrology has endorsed a practical core curriculum for interventional nephrology in PD available on the Society website, which is here reported for the wider nephrology community. The topics addressed are the hernias of the abdominal wall, catheter placement with standard surgical open technique, basic video-laparoscopy, advanced video-laparoscopy, video-laparoscopic cholecystectomy and catheter placement, cuff-shaving and video-laparoscopy in catheter malfunction.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1459-1465"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914689","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 prospective, observational study of a pediatric affect and cooperation scale (HRAD±) for vascular access procedures.","authors":"Romy Yun, Kristin M Kennedy, Janet Titzler, Avani Ganesan, Craig Yamaguchi, Michelle Zuniga-Hernandez, Meghana Renavikar, Ryan Brinda, Christian Jackson, Stacie Rohovit, Thomas J Caruso","doi":"10.1177/11297298241302897","DOIUrl":"10.1177/11297298241302897","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is common in pediatric patients, especially during vascular access procedures. Most well-studied affect and anxiety scales, including the Observation Scale of Behavioral Distress-Revised (OSBD-r), the modified Yale Preoperative Anxiety Scale (mYPAS), and the modified Induction Compliance Checklist (mICC), are too cumbersome for clinical use outside of research settings. HRAD± (Happy, Relaxed, Anxious, Distressed with yes/no to cooperation) is a clinically-efficient observational scale that evaluates pediatric procedural affect and cooperation. This study examined the clinical utility of HRAD± during vascular access procedures in children. The aims were to investigate the correlation of HRAD± to highly reliable, research-based affect and cooperation scales and to assess inter-rater reliability (IRR) between observers in this setting.</p><p><strong>Methods: </strong>This was a prospective, observational study conducted at Lucile Packard Children's Hospital Stanford. Inpatient participants were 1 month to 25 years old and undergoing a peripheral intravenous insertion or phlebotomy. Two trained research assistants (RAs) scored each patient independently during the vascular access procedure using HRAD±, OSBD-r, mYPAS, and mICC. Correlation analyses computed the associations between HRAD± and reference scales. IRR between RAs and vascular access providers was calculated using Fleiss' Kappa.</p><p><strong>Results: </strong>A total of 234 patients were included. HRAD± scores strongly correlated with OSBD-r and mYPAS (<i>p</i> < 0.0001, <i>p</i> < 0.0001, respectively). The cooperation assessment of HRAD± demonstrated strong correlation to mICC (<i>p</i> < 0.0001). IRR of HRAD± between research assistants and vascular access providers showed moderate agreement (<i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>HRAD± demonstrated strong correlation to the reference affect and cooperation scales. This study supports the utility of HRAD± for rapid assessment of pediatric procedural anxiety and cooperation during vascular access procedures. HRAD± can serve as a practical tool for facilitating clinical decisions, and its wider incorporation into healthcare settings would importantly guide targeted interventions to reduce patient anxiety.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1709-1716"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787782","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":"Clinical outcomes of peripherally inserted central catheters in patients with gastroenterological diseases: Report of a 9-year experience.","authors":"Takehito Yamamoto, Yoichiro Uchida, Jo Yano, Reo Nakano, Yoshiki Oshimo, Takashi Fujimoto, Koji Hisano, Kenzo Nakano, Takayuki Kawai, Yoshihisa Okuchi, Kohta Iguchi, Eiji Tanaka, Meiki Fukuda, Kojiro Taura, Hiroaki Terajima","doi":"10.1177/11297298241279063","DOIUrl":"10.1177/11297298241279063","url":null,"abstract":"<p><strong>Background: </strong>Peripherally inserted central catheters (PICCs) are safe and useful alternatives to centrally inserted central catheters (CICCs). Several studies have investigated the effectiveness and safety of PICCs; however, few have focused on their use in patients with gastroenterological diseases. In the present study, we evaluated the outcomes of patients with gastroenterological diseases who received PICCs and identified the risk factors associated with central line-associated blood stream infection (CLABSI).</p><p><strong>Methods: </strong>We retrospectively examined hospitalized patients at our institution who received PICCs between 2015 and 2023. We evaluated the data on their clinical characteristics, complications, and outcomes. Furthermore, we investigated the risk factors for CLABSIs.</p><p><strong>Results: </strong>A total of 405 patients were included (262 men and 143 women). The median age was 71 (range, 15-94) years. The vessels were inserted in the basilic, cephalic, and brachial veins in 366 (90%), 22 (6%), and 17 (4%) patients, respectively. The median procedure time was 32 [6-149] min. The median dwell time was 16 [0-188] days. CLABSI, catheter occlusions, phlebitis, and exit-site skin infection occurred in 14 (3.5%; 1.77/1000 catheter days), 6 (1.5%; 0.76/1000 catheter days), 3 (0.7%; 0.38/1000 catheter days), and 1 (0.2%; 0.13/1000 catheter days) patients, respectively. There was no case of deep vein thrombosis or pulmonary thrombosis due to PICC placement. Multivariate analysis performed using a Cox's proportional hazard regression model revealed that patients with gastroenterological malignancies had an independently higher risk for CLABSIs (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.05-10.05, <i>p</i> = 0.041) and that older age (⩾70 years) tended to be associated with CLABSIs (OR: 3.61, 95% CI: 0.98-13.32, <i>p</i> = 0.054).</p><p><strong>Conclusions: </strong>Gastroenterological malignancies and older age were associated with a higher risk of CLABSIs. Rigorous catheter management is crucial for preventing complications, particularly in vulnerable patient subgroups.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1482-1488"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333100","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":"Early postoperative resistance index can predict radiocephalic arteriovenous fistula failure.","authors":"Koji Inagaki, Chikao Onogi, Keita Iimuro, Akira Suzuki, Shin Furusawa, Masashi Tsuji, Toshiyuki Akahori","doi":"10.1177/11297298241295267","DOIUrl":"10.1177/11297298241295267","url":null,"abstract":"<p><strong>Background: </strong>Ultrasonography is valuable for assessing arteriovenous fistula (AVF) maturation. Brachial artery flow volume (FV) measured at 6 weeks post-AVF creation can predict AVF failure. However, the association between early postoperative FV and AVF failure remains unclear. The resistance index (RI) may also serve as a prognostic factor for AVF maturation; however, it has not been extensively studied. Therefore, we aimed to investigate the relationship between AVF failure and early postoperative FV and RI.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 102 patients (mean age, 67.8 ± 14.2 years; male, 68.6%; diabetes mellitus, 52.0%) who underwent new radiocephalic-AVF creation between January 2019 and December 2023 in Japan. An ultrasound device was used to measure brachial artery FV and RI on postoperative days 0 and 1. AVF failure was defined as occlusion or stenosis requiring vascular access intervention or surgical revision before the first cannulation, or cannulation difficulty or FV dysfunction requiring vascular access intervention or surgery at the first cannulation.</p><p><strong>Results: </strong>On postoperative day 0, FV was 383.1 ± 146.8 mL/min, and RI was 0.65 ± 0.11. On postoperative day 1, FV was 466.9 ± 179.2 mL/min, and RI was 0.62 ± 0.11. FV significantly increased, and RI was significantly reduced on postoperative day 1 compared to those on day 0 (<i>p</i> < 0.01). Multivariate analyses revealed that higher RI (per 0.1; odds ratio (OR), 2.16; 95% confidence interval (CI), 1.22-3.82), but not FV, was significantly associated with AVF failure on postoperative day 0. On postoperative day 1, lower FV (per 100 mL/min; OR, 0.63; 95% CI, 0.42-0.95) and higher RI (per 0.1; OR, 2.17; 95% CI, 1.16-4.05) were significantly associated with AVF failure.</p><p><strong>Conclusions: </strong>This study highlights RI as a predictor of AVF failure in the early postoperative period when vasospasm is likely to occur.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1610-1618"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor mid-term functional patency and post-operative outcomes in diabetic patients who undergo arteriovenous graft creation.","authors":"Colin M Cleary, Rong Wu, Kwame S Amankwah, Mina L Boutrous","doi":"10.1177/11297298241293493","DOIUrl":"10.1177/11297298241293493","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus is a leading cause of renal failure in the US and has been associated with higher mortality when compared to nondiabetic patients. This remains true despite initiation of renal replacement therapy. As such, we were interested in identifying any potential differences in access durability and postoperative outcomes in diabetic patients who receive arteriovenous fistulas versus grafts for hemodialysis.</p><p><strong>Methods: </strong>Diabetic patients undergoing their first arteriovenous (AV) access creation surgery in the Vascular Quality Initiative from January 2011 to January 2022 were included in our study. After exclusions, the study included two groups: those receiving AV fistulas and those receiving AV grafts for hemodialysis. Demographic characteristics were summarized and compared between these two groups using chi-square analysis or unpaired <i>t</i>-test. After propensity score matching was conducted, the effect of procedure type on functional patency, along with secondary outcomes including wound infection were assessed using chi-square analysis.</p><p><strong>Results: </strong>A total of 20,159 diabetic patients who used their hemodialysis access were included in our study; 16,205 received AV fistulas while 3954 received AV grafts. Patients receiving AV grafts were more likely to be older, female, and have higher pre-operative catheter usage. After propensity score matching, patients who received AV grafts had a shorter time-to-use their conduit (50 vs 166 days, <i>p</i> < 0.0001), however, patients who received AV fistulas were more likely to have longer functional patency use for hemodialysis when compared to those who received AV grafts (mean survival time: 3.3 vs 2.9 years, <i>p</i> < 0.0001). These results were consistent between diabetics with insulin-dependent or insulin-independent diabetes.</p><p><strong>Conclusion: </strong>Patients diagnosed with diabetes mellitus had an increased risk for significantly inferior clinical outcomes related to newly created AV grafts, including lower rates of mid-term functional patency and higher rates of worse post-operative outcomes when compared to diabetics who received AV fistulas.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1637-1644"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of percutaneous closure for decannulation of veno-arterial extracorporeal membrane oxygenation: A retrospective study.","authors":"Diana Martins-Fernandes, João Rocha-Neves, Ana Rita Ferreira, Hélio Martins, Sérgio Gaião, José Artur Paiva","doi":"10.1177/11297298241300119","DOIUrl":"10.1177/11297298241300119","url":null,"abstract":"<p><strong>Background: </strong>Despite the evidence supporting the use of Perclose Proglide^® (PP) suture-mediated vascular closure devices in various clinical scenarios, limited evidence exists regarding its role in percutaneous arterial closure of the femoral artery after venoarterial extracorporeal membrane oxygenation (VA-ECMO). Compared to conventional methods, this study evaluates the effectiveness and complications of bedside percutaneous femoral artery closure using Perclose ProGlide (PP) for VA-ECMO decannulation.</p><p><strong>Methods: </strong>Retrospective cohort of consecutive patients managed with mechanical circulatory support VA-ECMO for refractory cardiogenic shock, who survived decannulation between January 2017 and August 2023. A comparison between PP and other decannulation strategies was established to evaluate the effectiveness and procedure-related complications of bedside percutaneous femoral artery closure using a PP with a post-closure technique compared to conventional approaches of surgical and manual decannulation.</p><p><strong>Results: </strong>Among 122 patients decannulated from VA-ECMO with a mean age of 48.6 ± 13.1 and 78 (63.9) males, 49.2% comprised the PP group. Despite the older age (<i>p</i> = 0.021) and higher prevalence of arterial hypertension (<i>p</i> = 0.045), the PP group had a larger number of patients free from decannulation-related adverse events. Additionally, a higher haemoglobin level 24 h post decannulation (<i>p</i> = 0.047), with no difference in terms of transfusion of red blood cells between groups (<i>p</i> = 0.263) was found. The pseudoaneurysm was the most frequently reported complication, while the arterial cannulation surgical wound site infection was only documented in the open repair subgroup. A trend towards reduced Intensive Care (ICU) and hospital length of stay after decannulation was noted, although it did not reach statistical significance. There was no difference in mortality between both groups and no procedure-related deaths occurred. A mean of 2.7 PP devices were required to achieve complete haemostasis in the PP cohort, where technical failure was documented in four cases (6.7%).</p><p><strong>Conclusions: </strong>Bedside Percutaneous decannulation of VA-ECMO using a PP device with a post-closure technique is safe and reliable for achieving effective haemostasis, with fewer vascular complications than conventional approaches and a low device failure rate.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1651-1660"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}