Journal of Vascular Access最新文献

{"title":"Effect of different sealing caps on the backflow of short-term dialysis catheters: A bench study.","authors":"Daniele Privitera, Davide Giustivi, Thomas Langer, Elisabetta Fiorina, Federica Gotti, Michela Rossini, Beatrice Brunoni, Nicolò Capsoni, Alberto Dal Molin, Francesco Zadek","doi":"10.1177/11297298241301508","DOIUrl":"10.1177/11297298241301508","url":null,"abstract":"<p><strong>Background: </strong>Needle-free connectors (NFCs) are recommended as closure systems for peripheral and central vascular catheters to reduce needlestick injuries and infections, while potentially reducing blood reflux. However, their performance in short-term dialysis catheters has never been evaluated. The aim of this study was to evaluate the backflow associated with two NFCs (Neutron™ and Tego™) compared to the standard closure.</p><p><strong>Methods: </strong>In this bench study, the physiological blood pressure of the superior vena cava was simulated. Expert operators performed three sealing sequences for each combination of connector and lumens of the catheter, with and without closing the clamp. After that, the backflow was measured in millimeters using a high-precision digital caliper.</p><p><strong>Results: </strong>No combination of caps, lumens, or clamping sequences eliminated the backflow. No differences were observed between standard caps and NFCs in both lumens, apart from the Tego™/<i>No clamp</i> combination in the proximal lumen that showed higher backflow (standard cap 15 [11; 17] mm vs Tego™ 23 [19; 25] mm, <i>p</i> < 0.001). Clamping reduced backflow in both the proximal (13 [11; 17] mm vs 20 [13; 25] mm) and distal lumens (12 [11; 16] mm vs 14 [12; 17] mm). No differences were found between standard caps and NFCs in the distal lumen, regardless of clamping. Proximal lumen consistently exhibited larger backflow (14 [12; 22] mm) compared to distal lumens (13 [11; 17] mm, <i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>NFCs do not seem to introduce any advantage on backflow reduction as compared to a standard cap combined with lumen and clamping. Our data suggest that clamping should become standard practice when NFCs are used in the management of short-term dialysis catheters.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1717-1723"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792470","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":"Retrospective analysis of 1028 ultrasound-guided central vascular access in neonates and children.","authors":"Pablo D'Alessandro, Juan Ignacio Siffredi, Emiro Redondo Pertuz, Paula Flores, Trinidad Ruiz Germán, Mariano Boglione, Marcelo Barrenechea","doi":"10.1177/11297298241278385","DOIUrl":"10.1177/11297298241278385","url":null,"abstract":"<p><strong>Background: </strong>The use of real-time ultrasound has become the standard of care for percutaneous central venous access and shown to decrease overall number of attempts and complication rates.</p><p><strong>Material and method: </strong>A retrospective analysis of a prospective database was done focusing on three types of central access: non-tunneled, tunneled, and implantable, placed via ultrasound-guided Brachiocephalic Vein (BCV) between January 2019 and January 2023. Data were recorded: gender, age, weight, side (left or right), number of puncture attempts, arterial puncture, change of operator or puncture side, and mechanical complications (pneumothorax and hemothorax).</p><p><strong>Results: </strong>A total of 1028 non-tunneled, tunneled, and implantable central lines were placed. Five hundred and eighty seven were Male. The children were aged from 0 to 18 years and their weights ranged from 1 to 113 kg. Nine hundred and thirty-five were left BCV. Right BCV was cannulated in 93 patients. Failure to cannulate left BCV was recorded in seven cases. Three arterial punctures were recorded. Cannulation success rate was 97.2% (999/1028) and was higher in left BCV than right BCV (<i>p</i> < 0.001).</p><p><strong>Discussion: </strong>Based on the above, we believe that ultrasound-guided BCV is an easy and secure method to cannulate children, in our series left BCV showed a higher cannulation success rate rather than right BCV.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1739-1745"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333115","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":"Cephalic to jugular vein bypass surgery of subclavian vein stenosis for arteriovenous fistula salvage in maintenance hemodialysis patients.","authors":"Min Gao, Ming-Ming Pan, Yu-Chen Han","doi":"10.1177/11297298241300124","DOIUrl":"10.1177/11297298241300124","url":null,"abstract":"<p><strong>Background: </strong>Ipsilateral subclavian vein stenosis in a well-functioning upper extremity arteriovenous fistula (AVF) is a significant factor contributing to AVF failure and sometimes swelling of ipsilateral upper extremity. Graft bypass surgery can alleviate outflow tract stenosis in upper extremity AVF, restore function, and efficiently relieve arm swelling. The present study aimed to evaluate patency and postoperative complications after cephalic to jugular graft bypass surgery in patients with upper extremity AVF failure or upper extremity swelling on the same side of the AVF resulting from ipsilateral subclavian vein stenosis.</p><p><strong>Methods: </strong>Five patients with upper extremity AVF and ipsilateral subclavian vein stenosis undergoing maintenance hemodialysis were included. Three patients had AVF dysfunction, while two experienced swelling of the arm due to high venous pressure in the AVF. The surgical procedure involved creating a subcutaneous tunnel in the shoulder to connect a 6 mm polytetrafluorethylene (PTFE) graft, from either near the fistula site (<i>n</i> = 3) or at the mid-upper arm cephalic vein (<i>n</i> = 2), to the jugular vein.</p><p><strong>Results: </strong>Graft bypass surgery was successful, and all patients were able to resume hemodialysis postoperatively. Upper extremity edema improved, without any postoperative wound infections, non-healing wounds, steal syndrome, or high-flow AVF leading to heart failure as a complication. Five to 19 months after surgery, the bypass grafts exhibited a primary patency rate of 100%, and vascular access fulfilled the requirements for hemodialysis.</p><p><strong>Conclusions: </strong>Cephalic to jugular vein bypass surgery for upper extremity AVF with ipsilateral subclavian vein stenosis effectively preserved function of the original fistula, and was associated with few postoperative complications.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1673-1680"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711043","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":"Retraction: \"Brachial plexus block using only 1% lidocaine to reduce pain during the endovascular treatment of dysfunctional arteriovenous access\".","authors":"","doi":"10.1177/11297298251365708","DOIUrl":"10.1177/11297298251365708","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1788"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849704","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 qualitative study of factors influencing evidence-based practice of blood collection by clinical nurses via central venous access devices.","authors":"Yan Qian, Wangqin Shen, Yi Qin, Xiaohong Jin, Feihong Hu","doi":"10.1177/11297298241282268","DOIUrl":"10.1177/11297298241282268","url":null,"abstract":"<p><strong>Background: </strong>Several studies have upheld the advantages of blood collection using via central venous access device (CVAD); the procedure has a high success rate and avoids painful repeated punctures. Some studies have suggested that via central venous access device (CVAD) blood collection is preferable for acute and critical care, oncology, and pediatric patients. However, there is no consensus on or standardization of this approach.</p><p><strong>Purpose: </strong>To explore the facilitators of and barriers factors of evidence-based decision-making in CVAD blood collection in clinical practice.</p><p><strong>Methods: </strong>This was a qualitative study guided by phenomenological research. A purposive sampling method was used to select 13 clinical nurses from two public hospitals in China to conduct semi-structured personal interviews. The interview outline was designed based on a literature review and the i-PARIHS theoretical framework, and information was organized and analyzed using the Colaizzi 7-step analysis method.</p><p><strong>Results: </strong>Two themes and seven sub-themes were derived from the analysis of interview data. Facilitating factors: (1) nurses' trust the evidence-based nursing decisions; (2) low rate of operational complications; (3) high success rate of blood collection; (4) nurses' sense of professional benefit; Hindering factors: (1) preparation of operational materials and time-consuming operation; (2) nursing interruptions; (3) patients' economic factors. The interview data showed that CVAD blood collection is suitable for critically ill patients, children, patients with poor venous conditions and poor cooperation.</p><p><strong>Conclusion: </strong>This study provides guidance for advancing the clinical application of evidence-based CVAD blood collection. Evidence-based nursing culture, operational advantages, and nurses' sense of professional benefit were effective facilitators of the evidence-based practice. Researchers need to optimize the operating materials and methods, and comprehensively consider multiple factors to promote the better application of evidence.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1563-1568"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481860","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":"International experts consensus on optimal central vascular access device selection and management for patients with cancer.","authors":"Mohammad Jahanzeb, Ching-Yang Wu, Howard Lim, Kei Muro, Lichao Xu, Manjiri Somashekhar, S P Sampige Prasannakumar Somashekhar, Xiaotao Zhang, Xiaoxia Qiu, Ying Fu, Mauro Pittiruti","doi":"10.1177/11297298241300792","DOIUrl":"10.1177/11297298241300792","url":null,"abstract":"<p><strong>Background: </strong>In patients with cancer, the choice of an appropriate venous access device is crucial for effective treatment, minimizing complications, and reducing healthcare costs. Key management decisions, such as the timing of device removal post-therapy, can impact clinical outcomes. As current international guidelines lack specific directives for these issues, a global consensus of experts, representing different countries, was deemed appropriate.</p><p><strong>Methods: </strong>A panel of 11 experts from three continents, including oncologists and healthcare professionals, was chosen. After a comprehensive review of clinical trials and guidelines on central venous access devices (CVAD) in oncology published between January 2013 and December 2023, the panel developed and voted on specific recommendations for the selection and management of CVADs in patients with cancer, during a 2-day meeting.</p><p><strong>Results: </strong>The panel reached consensus on 10 issues concerning (a) indications for a CVAD, (b) available options for CVADs, (c) role of the staff and patients in the choice of CVAD, (d) factors influencing the selection of a port over an external catheter, (e) logistical requirements for port and external catheter insertion, (f) stakeholders responsible for port and external catheter insertion, (g) factors determining the removal of a port after completing the definitive therapy, and (h) recommended frequency of flushing when the CVAD is not in use.</p><p><strong>Conclusions: </strong>The results of the consensus may offer healthcare professionals a global view of some critical issues concerning CVADs for cancer therapy, helping to establish recommendations for local clinical practice.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1447-1458"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775015","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":"Distal radial artery palpability and successful arterial access for coronary angiography: A post-hoc analysis from two randomized trials.","authors":"Anastasios Apostolos, Amalia Papanikolaou, Angeliki Papageorgiou, Athanasios Moulias, Georgios Vasilagkos, Konstantinos Pappelis, Adel Aminian, Gregory A Sgueglia, Juan F Iglesias, Periklis Davlouros, Grigorios Tsigkas","doi":"10.1177/11297298241296570","DOIUrl":"10.1177/11297298241296570","url":null,"abstract":"<p><strong>Background: </strong>Distal radial artery access (DRA) has been emerged as an alternative for conventional transradial arterial access. While palpation of radial artery is mandatory prior coronary angiography, it remains unknown the clinical impact of palpation in DRA success. Aim of our study is to explore whether the palpability of distal radial artery is linked with higher rates of successful arterial access.</p><p><strong>Methods: </strong>We conducted a post-hoc analysis using data from two randomized-controlled trials on DRA. All patients with available data on distal radial artery palpability and cannulation's success were included in our analysis. No procedure was performed with ultrasound guidance.</p><p><strong>Results: </strong>Data on the palpability of the distal radial artery and the DRA success were available for 435 patients. Successful distal radial artery cannulation was attempted in 255 and 98 of patients with and without palpable distal radial artery, respectively. No significant difference between the two groups was observed (81.5% vs 80.3%, <i>p</i> = 0.786). Univariate analysis revealed statistically significant difference in gender, height, known CAD, valvular disease as indication for angiography and number of skin punctures. Multivariate analysis included these variables, as well as palpability of the distal radial artery and found that number of skin punctures and valvular disease as indication are significantly associated with DRA success.</p><p><strong>Conclusion: </strong>According our post-hoc analysis, the palpability of the distal radial artery is not associated with higher rates of DRA success. Further studies are required for the validation of these results.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1724-1731"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792463","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 affecting the unused short peripheral catheters: A neverending debate? A cross-sectional study in hospitalized patients.","authors":"Federica Canzan, Jessica Longhini, Elisabetta Allegrini, Giulia Marini, Elisabetta Mezzalira, Giorgia Zulianello, Elisa Ambrosi","doi":"10.1177/11297298241303200","DOIUrl":"10.1177/11297298241303200","url":null,"abstract":"<p><strong>Background: </strong>Concern about unused vascular access devices has increased, but data on idle short peripherally intravascular catheters in medical-surgical units is still scarce. We aimed to assess the prevalence of unused short peripheral catheters in hospitalized patients and identify risk factors and reasons that lead nurses to maintain them in situ.</p><p><strong>Methods: </strong>A cross-sectional observational study was performed in September 2022. Clinical observation (24h) and medical records review were assessed to collect patient demographics and catheter-related information. Nurses were asked the main reason for continuing the use of the unused catheter. The primary outcome was the prevalence of unused short peripheral catheters, which were no longer used for intravenous fluids or medications in the previous 24 h. Multivariate logistic regression has been performed to evaluate risk factors for unused catheters. The STROBE checklist was used to report our study.</p><p><strong>Results: </strong>Seven hundred and sixty-four patients were included; out of the 621 patients with at least one short peripheral catheter, one-third had at least one unused catheter. The risk of having an unused peripherally intravascular catheter was almost double when the catheter was positioned in the emergency department. Catheters of smaller calibers and in situ for fewer days were less likely to be unused. The main reasons for keeping a peripherally intravascular catheter unused in situ were clinical conditions.</p><p><strong>Conclusion: </strong>Unused short peripheral catheters are still quite frequent. While specific clinical needs justified some unused short peripheral catheters, a proportion remained unexplained and potentially avoidable. Nurses and policymakers can use the findings to inform decision-making and protocols to manage peripherally inserted catheters to reduce unused short peripheral catheters and, consequently, complications and costs and improve patient safety and quality of care.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1732-1738"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803447","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 novel technique for snuffbox fistula creation.","authors":"Xiaohe Wang, Jia Zhi, Guocun Hou","doi":"10.1177/11297298241292116","DOIUrl":"10.1177/11297298241292116","url":null,"abstract":"<p><strong>Background: </strong>In this pilot study, we describe a novel technique for creating a snuffbox fistula (SBF) and present the preliminary outcomes after 4-6 weeks of follow-up.</p><p><strong>Methods: </strong>The study included eight male patients with a mean age of 50 years (range 36-66 years). All patients received an SBF using the modified no-touch technique (MNTT) and piggyback straight-line on-lay technique (pSLOT).</p><p><strong>Results: </strong>Immediate patency was obtained for all patients. In one case, a thrombosis developed at the juxta anastomosis. The remaining seven SBFs met the clinical arteriovenous fistula maturity criteria at the physical examination performed 4-6 weeks after surgery, showing an easily palpable vein, a straight superficial segment >10 cm in length and a sufficient diameter, and good palpable thrill. In addition, an ultrasound examination showed that the diameter of the drainage vein was 4-6 mm, and the brachial blood flow was ⩾500 mL/min.</p><p><strong>Conclusions: </strong>The combination of MNTT and pSLOT was used to successfully establish SBFs, and the success rate of surgery and access maturity were high.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1754-1759"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513622","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 between the halfway technique and the standard technique for exchange of tunneled hemodialysis catheter.","authors":"Adel Kamhawy, AbdelRahman A Nagy, Emad M Sallam","doi":"10.1177/11297298241286203","DOIUrl":"10.1177/11297298241286203","url":null,"abstract":"<p><strong>Objectives: </strong>When indicated, tunneled hemodialysis catheters are usually inserted using the standard technique but, this technique has its complications. The halfway method is performed by exchange of an already-inserted dialysis catheter (tunneled or non-tunneled) to a tunneled one over a guidewire mounted via the old catheter. In this study, we aimed at evaluating the feasibility, safety, and durability of halfway method in comparison to the standard technique (de novo puncture).</p><p><strong>Patients and methods: </strong>This prospective study was conducted during the period from May 2020 till May 2022 and included 87 patients with end-stage renal disease (ESRD) on regular hemodialysis (HD) in need for insertion new tunneled dialysis catheters instead of temporary or malfunctioning tunneled ones. According to the technique of catheter insertion, these patients were divided into two groups: group A (the halfway technique: catheters were exchanged over guidewires under fluoroscopic control; 48 patients) and group B (the standard technique: via de novo ultrasound-guided vein puncture; 39 patients). Instant, delayed complications and 12-months patency rates were reported and analyzed.</p><p><strong>Results: </strong>The frequency of peri-operative bleeding complications was better in the halfway group with comparable infection rate and late catheter dysfunction results between the two groups. One year patency rates were 87.5% in halfway technique group compared to 79.5% in standard technique group, yet without statistical significance. However, there was a statistically significant shorter operative time in halfway group (15.54 ± 2.6 min vs 26.97 ± 5.6 min, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The halfway technique may be recommended over the standard technique of tunneled catheter insertion due to shorter operative time, lower rate of hematoma formation, with non-inferior 1-year patency rates and comparable technical success and infection rates. The advantage of access sites preservation for future demand makes this technique of great value to this group of ESRD patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1539-1546"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382495","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}