Arteriovenous Shunt, Surgical: Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed)Arteriovenous Fistula: An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.Cranial Sinuses: Large endothelium-lined venous channels situated between the two layers of DURA MATER, the endosteal and the meningeal layers. They are devoid of valves and are parts of the venous system of dura mater. Major cranial sinuses include a postero-superior group (such as superior sagittal, inferior sagittal, straight, transverse, and occipital) and an antero-inferior group (such as cavernous, petrosal, and basilar plexus).Central Nervous System Vascular Malformations: Congenital, inherited, or acquired abnormalities involving ARTERIES; VEINS; or venous sinuses in the BRAIN; SPINAL CORD; and MENINGES.Arteriovenous Malformations: Abnormal formation of blood vessels that shunt arterial blood directly into veins without passing through the CAPILLARIES. They usually are crooked, dilated, and with thick vessel walls. A common type is the congenital arteriovenous fistula. The lack of blood flow and oxygen in the capillaries can lead to tissue damage in the affected areas.Cerebral Veins: Veins draining the cerebrum.Arteriovenous Anastomosis: A vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula.Intracranial Arteriovenous Malformations: Congenital vascular anomalies in the brain characterized by direct communication between an artery and a vein without passing through the CAPILLARIES. The locations and size of the shunts determine the symptoms including HEADACHES; SEIZURES; STROKE; INTRACRANIAL HEMORRHAGES; mass effect; and vascular steal effect.Fluorocarbon PolymersBleeding Time: Duration of blood flow after skin puncture. This test is used as a measure of capillary and platelet function.Dura Mater: The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord.Phenindione: An indandione that has been used as an anticoagulant. Phenindione has actions similar to WARFARIN, but it is now rarely employed because of its higher incidence of severe adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p234)Embolization, Therapeutic: A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.Ventriculoperitoneal Shunt: Surgical creation of a communication between a cerebral ventricle and the peritoneum by means of a plastic tube to permit drainage of cerebrospinal fluid for relief of hydrocephalus. (From Dorland, 28th ed)Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Cerebrospinal Fluid Shunts: Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles.Skin Temperature: The TEMPERATURE at the outer surface of the body.Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.Cerebral Angiography: Radiography of the vascular system of the brain after injection of a contrast medium.Jugular Veins: Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins.Papio: A genus of the subfamily CERCOPITHECINAE, family CERCOPITHECIDAE, consisting of five named species: PAPIO URSINUS (chacma baboon), PAPIO CYNOCEPHALUS (yellow baboon), PAPIO PAPIO (western baboon), PAPIO ANUBIS (or olive baboon), and PAPIO HAMADRYAS (hamadryas baboon). Members of the Papio genus inhabit open woodland, savannahs, grassland, and rocky hill country. Some authors consider MANDRILLUS a subgenus of Papio.Portasystemic Shunt, Surgical: Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval.Regional Blood Flow: The flow of BLOOD through or around an organ or region of the body.Angiography: Radiography of blood vessels after injection of a contrast medium.Portacaval Shunt, Surgical: Surgical portasystemic shunt between the portal vein and inferior vena cava.Peritoneovenous Shunt: An operation for the continuous emptying of ascitic fluid into the venous system. Fluid removal is based on intraperitoneal and intrathoracic superior vena cava pressure differentials and is performed via a pressure-sensitive one-way valve connected to a tube traversing the subcutaneous tissue of the chest wall to the neck where it enters the internal jugular vein and terminates in the superior vena cava. It is used in the treatment of intractable ascites.Platelet Aggregation: The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS.Dogs: The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, INTRACRANIAL HYPERTENSION; HEADACHE; lethargy; URINARY INCONTINENCE; and ATAXIA.Hypertension, Portal: Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.Esophageal and Gastric Varices: Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).Hepatic Encephalopathy: A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)Heart Septal Defects, Atrial: Developmental abnormalities in any portion of the ATRIAL SEPTUM resulting in abnormal communications between the two upper chambers of the heart. Classification of atrial septal defects is based on location of the communication and types of incomplete fusion of atrial septa with the ENDOCARDIAL CUSHIONS in the fetal heart. They include ostium primum, ostium secundum, sinus venosus, and coronary sinus defects.Splenic Vein: Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery.Portal System: A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system.Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein.Ascites: Accumulation or retention of free fluid within the peritoneal cavity.Heart Septal Defects: Abnormalities in any part of the HEART SEPTUM resulting in abnormal communication between the left and the right chambers of the heart. The abnormal blood flow inside the heart may be caused by defects in the ATRIAL SEPTUM, the VENTRICULAR SEPTUM, or both.Gastrointestinal Hemorrhage: Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.Hydrocephalus, Normal Pressure: A form of compensated hydrocephalus characterized clinically by a slowly progressive gait disorder (see GAIT DISORDERS, NEUROLOGIC), progressive intellectual decline, and URINARY INCONTINENCE. Spinal fluid pressure tends to be in the high normal range. This condition may result from processes which interfere with the absorption of CSF including SUBARACHNOID HEMORRHAGE, chronic MENINGITIS, and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp631-3)Renal Veins: Short thick veins which return blood from the kidneys to the vena cava.Pulmonary Circulation: The circulation of the BLOOD through the LUNGS.Foramen Ovale, Patent: A condition in which the FORAMEN OVALE in the ATRIAL SEPTUM fails to close shortly after birth. This results in abnormal communications between the two upper chambers of the heart. An isolated patent ovale foramen without other structural heart defects is usually of no hemodynamic significance.Heart Bypass, Right: Diversion of the flow of blood from the entrance to the right atrium directly to the pulmonary arteries, avoiding the right atrium and right ventricle (Dorland, 28th ed). This a permanent procedure often performed to bypass a congenitally deformed right atrium or right ventricle.General Surgery: A specialty in which manual or operative procedures are used in the treatment of disease, injuries, or deformities.Cellular Phone: Analog or digital communications device in which the user has a wireless connection from a telephone to a nearby transmitter. It is termed cellular because the service area is divided into multiple "cells." As the user moves from one cell area to another, the call is transferred to the local transmitter.Specialties, Surgical: Various branches of surgical practice limited to specialized areas.Surgery Department, Hospital: Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.Surgical Procedures, Operative: Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)Cyclization: Changing an open-chain hydrocarbon to a closed ring. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed)Aldehydes: Organic compounds containing a carbonyl group in the form -CHO.

Sites of stenosis in AV fistulae for haemodialysis access. (1/955)

BACKGROUND: A large proportion of late failures of radiocephalic arteriovenous fistulae are related to the progression of intimal hyperplasia. The aetiology of this process is still unknown but the fistula configuration and resultant haemodynamics have been implicated. This clinical study was devised to identify sites of stenosis in patients with fistulae and relate the findings to various clinical and geometrical parameters. METHOD: Measurement of anastomotic length and angle was made intraoperatively in 25 consecutive fistulae. Post-operative assessment was carried out at regular intervals using duplex and colour-flow ultrasonography. RESULTS: Stenoses were present in all 25 of the fistulae studied at 3 months. The stenoses could be classified to three specific sites: at the anastomosis (Type 1), on the inner wall of the curved region of the cephalic vein (Type 2) and just proximal to this curved segment where the vein straightens out (Type 3). Most of Type 1 and Type 2 stenoses were not progressive while Type 3 stenoses were generally progressive. CONCLUSION: These findings emphasize the need for an effective surveillance programme of AV fistulae.  (+info)

Association of plasma fibrinogen concentration with vascular access failure in hemodialysis patients. (2/955)

BACKGROUND: Elevated plasma fibrinogen is an important risk factor for coronary artery disease in the general population and patients with chronic renal failure. High plasma fibrinogen may trigger thrombus formation in arteriovenous fistulas. We performed a prospective, cohort study to evaluate the association of plasma fibrinogen concentration with vascular access failure in patients undergoing long-term haemodialysis. METHODS: Between September 1989 and October 1995, 144 patients underwent a vascular access operation. In March 1997, 102 patients (56 M, 46 F) who had been followed up for more than 18 months (median; 37 months, range; 18-102 months) were included in the study. The median age of the patients was 52 years (range; 19-78 years). In 35 patients, renal disease was secondary to diabetes mellitus. The type of vascular access was a polytetrafluoroethylene (PTFE) graft in 17 patients. Seventy-seven patients received recombinant human erythropoietin (r-HuEPO) therapy during the follow-up period. Plasma fibrinogen, albumin, total cholesterol, hematocrit, platelets and creatinine were measured at the time of operation. Vascular access failure was defined as the occurrence of complications requiring transluminal angioplasty, thrombolytic therapy or surgical repair. RESULTS: Thirty-eight patients had at least one vascular access failure and the incidence was 0.3 (range; 0-2.4) episodes per patient-year. The survival rate of vascular access was 78% (native fistula; 80%, PTFE graft; 71%) after 12 months and 70% (native fistula; 73%, PTFE graft; 51%) after 24 months. Older age, a PTFE graft, r-HuEPO therapy, higher hematocrit, lower albumin and higher fibrinogen levels were significantly associated with vascular access failure, whereas gender, diabetes mellitus, total cholesterol and platelet count were not. Plasma fibrinogen was inversely correlated with albumin (r=-0.38, P=0.001). The cumulative vascular access survival was significantly lower in patients with high plasma fibrinogen levels (> or = 460 mg/dl) compared with patients with low levels (< 460 mg/dl) (P=0.007). Independent risk factors for vascular access failure analysed by Cox's proportional hazards model were older age (RR; 1.36 by 10-year increment), higher fibrinogen level (RR; 1.20 by 100 mg/dl increment), PTFE graft (RR; 2.28) and r-HuEPO therapy (RR; 3.79). CONCLUSION: High plasma fibrinogen level is an independent risk factor for vascular access failure in haemodialysis patients.  (+info)

Right atrial bypass grafting for central venous obstruction associated with dialysis access: another treatment option. (3/955)

PURPOSE: Central venous obstruction is a common problem in patients with chronic renal failure who undergo maintenance hemodialysis. We studied the use of right atrial bypass grafting in nine cases of central venous obstruction associated with upper extremity venous hypertension. To better understand the options for managing this condition, we discuss the roles of surgery and percutaneous transluminal angioplasty with stent placement. METHODS: All patients had previously undergone placement of bilateral temporary subclavian vein dialysis catheters. Severe arm swelling, graft thrombosis, or graft malfunction developed because of central venous stenosis or obstruction in the absence of alternative access sites. A large-diameter (10 to 16 mm) externally reinforced polytetrafluoroethylene (GoreTex) graft was used to bypass the obstructed vein and was anastomosed to the right atrial appendage. This technique was used to bypass six lesions in the subclavian vein, two lesions at the innominate vein/superior vena caval junction, and one lesion in the distal axillary vein. RESULTS: All patients except one had significant resolution of symptoms without operative mortality. Bypass grafts remained patent, allowing the arteriovenous grafts to provide functional access for 1.5 to 52 months (mean, 15.4 months) after surgery. CONCLUSION: Because no mortality directly resulted from the procedure and the morbidity rate was acceptable, this bypass grafting technique was adequate in maintaining the dialysis access needed by these patients. Because of the magnitude of the procedure, we recommend it only for the occasional patient in whom all other access sites are exhausted and in whom percutaneous dilation and/or stenting has failed.  (+info)

Volume flow measurement in hemodialysis shunts using time-domain correlation. (4/955)

Volume flow was measured in 58 hemodialysis shunts (32 grafts and 26 radial fistulas) using the color velocity imaging-quantification method. This method is based on time-domain correlation for velocity calculation and integration of time-varying velocity profiles generated by M-mode sampling. Measurements were made in the brachial artery to estimate radial fistula flow or directly in the grafts. Intraoperator reproducibility was 14.9% for fistulas and 11.6% for grafts. Flow rate was significantly lower in abnormal shunts associated with a functional disorder or a morphologic complication (808 ml/min +/- 484) than in shunts associated with no abnormalities (1401 ml/min +/- 562). Receiver operating characteristic curves showed that a flow rate of 900 ml/min for fistulas and 1300 ml/min for grafts provided 81% and 79% sensitivity and 79% and 67% specificity, respectively. A functional disorder or a morphologic complication was associated with all fistulas and grafts in which flow rates were lower than 500 ml/min and 800 ml/min, respectively.  (+info)

Prospective randomised trial of distal arteriovenous fistula as an adjunct to femoro-infrapopliteal PTFE bypass. (5/955)

OBJECTIVES: To compare graft patency and limb salvage rate following femoro-infrapopliteal bypass using ePTFE grafts with and without the addition of adjuvant arterio-venous fistula. DESIGN: A prospectively randomised controlled trial. MATERIALS: Patients referred to two teaching hospital vascular surgery units in the U.K. for the treatment of critical limb ischaemia. METHODS: Eighty-seven patients (M:F; 2.3:1) undergoing 89 femoro-intrapopliteal bypass operations with ePTFE grafts for critical limb ischaemia were randomly allocated to have AVF included in the operative procedure (n = 48) or to a control group without AVF (n = 41). An interposition vein-cuff was incorporated at the distal anastomosis in all patients. RESULTS: The cumulative rates of primary patency and limb salvage at 1-year after operation for patients with AVF were 55.2% and 54.1% compared to 53.4% and 43.2%, respectively, for the control group. The differences between the AVF and control groups did not reach statistical significance, in terms of either graft patency or limb salvage, at any stage after operation (Log-Rank test). CONCLUSIONS: AVF confers no additional significant clinical advantage over interposition vein cuff in patients having femoro-infrapopliteal bypass with ePTFE grants for critical limb ischaemia.  (+info)

Homocyst(e)ine and vascular access complications in haemodialysis patients: insights into a complex metabolic relationship. (6/955)

BACKGROUND: As elevated total homocyst(e)ine (tHcy) is associated with increased risk of vascular thrombosis, we hypothesized that the elevated levels of tHcy seen in patients on haemodialysis may be associated with an increased risk of thrombosis of native arteriovenous fistulae (vascular access failure). Our study was designed to investigate the relationship between tHcy and vascular access failure. The relationship between tHcy and mortality was explored as a secondary analysis. METHODS: The study comprised a cross-sectional analysis of 96 haemodialysis patients at a single university-affiliated hospital and a subsequent 9-month prospective follow-up of 88 of the 96 patients. RESULTS: Levels of tHcy (median 30 micromol/l) were elevated. In the initial cross-sectional sample, there was an inverse relationship between tHcy and history of vascular access failure which was not observed in the prospective study. Variables influencing the risk of vascular access failure in the prospective study included history of previous vascular access failure (RR=2.93, P=0.03), use of antiplatelet agents (RR=0.13, P=0.01), increased urea reduction ratio (RR=0.55 for a 5% increase, P=0.01) and increased weight (RR=0.61 for a 10 kg increase, P=0.02). Secondary analysis showed an unexpected inverse relationship between tHcy and mortality (RR=0.033 for 1 log increase in tHcy, P=0.006), such that the lower levels of tHcy were associated with an increased risk of death in short-term follow-up. CONCLUSION: We did not demonstrate a relationship between tHcy and risk of vascular access failure. Patients with the lowest levels of tHcy appeared to be at increased risk of death in this short-term follow-up. The relationship of tHcy to vascular access complications and death in haemodialysis patients appears complex and requires further study.  (+info)

Effects of arteriovenous fistulas on cardiac oxygen supply and demand. (7/955)

BACKGROUND: Arteriovenous (AV) fistulas used for hemodialysis access may affect cardiac load by increasing the preload while decreasing the afterload. In dogs, AV fistulas have also been shown to affect coronary perfusion negatively. We investigated the net effect of AV fistulas on cardiac oxygen supply and demand. METHODS: Aortic pressure waves were reconstructed from finger pressure recordings obtained on the nonfistula arm using a wave-form filter. Changes in systolic, mean, and diastolic aortic pressure were calculated, together with changes in heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) during a 60-second compression of AV fistulas in 10 patients. Changes in cardiac supply and demand were estimated by calculating the area under the aortic pressure curve during diastole [diastolic pressure time index (DPTI)] and systole [systolic pressure time index (SPTI)], respectively. RESULTS: During fistula compression, systolic, mean and diastolic pressure increased by 4.2 +/- 4.3, 2.6 +/- 3.0, and 2.8 +/- 2.9 mm Hg (mean +/- SD, all P < 0.05). The HR decreased by 3.8 +/- 2.5 beats per minute (P < 0.01), and SV decreased 3.7 +/- 6.1% (NS). CO decreased 9.4 +/- 8.6%, and SVR increased 14.3 +/- 11.7% (both P < 0.05). The SPTI increased by 1.5 +/- 1.5 mm Hg.sec (P < 0.01), and the DPTI increased by 7.6 +/- 8.1 mm Hg.sec (14.8% increase, P < 0.05) during compression. The ratio of supply and demand (DPTI/SPTI) improved by 13.5 +/- 13.0% (P < 0.01) when the fistula was compressed. CONCLUSION: AV fistulas have a small effect on left ventricular oxygen demand, but decrease cardiac oxygen supply considerably.  (+info)

Differential regulation of IGF-I, its receptor and GH receptor mRNAs in the right ventricle and caval vein in volume-loaded genetically hypertensive and normotensive rats. (8/955)

It has been suggested, mainly by in vitro findings, that cardiovascular tissue in the spontaneously hypertensive rat (SHR) should be more prone to proliferate/hypertrophy than that of the Wistar-Kyoto rat (WKY). The present study tests the hypothesis that the tissue of the low-pressure compartment in SHR, being structurally similar to that of the WKY, shows an increased growth response due to activation of the GH-IGF-I system. An aortocaval fistula (ACF) was induced in 64 SHR and WKY male rats and 44 rats served as controls. They were all followed for 1, 2, 4 and 7 days after surgery. In separate groups of SHR (n=4) and WKY (n=3), central venous pressure was measured by telemetry recordings prior to opening of the fistula and for up to 16 h post-surgery. Systolic blood pressure was measured during the week post-surgery. The right ventricular (RV) and the caval vein IGF-I mRNA and RV IGF-I receptor and GH receptor mRNAs were quantitated by means of solution hybridisation assay. In rats with ACF the systolic blood pressure decreased, approximately 29% in SHR and 16% in WKY between 1 and 7 days post-surgery (P<0.05, n=5-6 in each group). SHR with ACF showed a transient elevation in central venous pressure vs WKY. Within the week following fistula induction both strains showed a similar, pronounced increase in RV hypertrophy. SHR with ACF showed a smaller, or even blunted, overall response with respect to activation of the GH-IGF-I system compared with WKY, the latter showing clear-cut elevation of gene expressions. Two days after shunt opening in SHR, RV and caval vein IGF-I mRNA increased by 57% and 108% (P<0.05 for both, n=5-6 in each group) respectively, and these expressions were then turned off, whereas RV GH receptor and IGF-I receptor mRNA expression remained unaffected compared with WKY rats. WKY rats showed on average a later and a greater response of GH-IGF-I system mRNA expression vs SHR. The present in vivo study suggests that the SHR requires less activation of the GH-IGF-I system for creating a given adaptive structural growth response.  (+info)

TY - JOUR. T1 - Mechanisms of angioplasty in hemodialysis fistula stenoses evaluated by intravascular ultrasound. AU - Davidson, Charles J.. AU - Newman, Glenn E.. AU - Sheikh, Khalid H.. AU - Kisslo, Katherine. AU - Stack, Richard S.. AU - Schwab, Steve J.. PY - 1991/7/1. Y1 - 1991/7/1. N2 - Mechanisms of angioplasty in hemodialysis fistula stenoses evaluated by travascular ultrasound. Quantification of luminal dimensions and the mechanisms by which angioplasty (PTA) corrects non-atheroma venous stula stenoses have been poorly studied. In 38 consecutive percutaeous balloon angioplasties of hemodialysis fistula stenoses, catheterbased, mechanically-rotated intravascular ultrasound (IVUS) images were obtained along with cineangiography. Images from 24 brachial vein, 11 central vein, 2 graft anastomoses, and 1 brachial artery were quantitatively and qualitatively evaluated. Semiautomated quantitative angiographic stenosis was 64 ± 13% pre-PTA and reduced to 36 ± 19% post-PTA (P , 0.001). ...
Objective: To investigate the reason of autogenous arteriovenous fistula failure by analyzing the clinical data of 32 hemodialysis patients in the Dep..
The arteriovenous fistula is considered to be the gold standard form of access for haemodialysis patients, however only 37% of haemodialysis patients have this form of access. A possible explanation for this could be the high fistula failure rate due to the lack of maturation. Therefore interventions aimed at enhancing fistula maturation are warranted. One such intervention could be forearm exercise, however this recommendation is not evidence based. Therefore, the purpose of this study is to investigate whether a program of post operative progressive hand grip exercise can improve fistula maturation ...
TY - JOUR. T1 - Assessment of brachial artery mechanics using velocity vector imaging does not predict arteriovenous fistula failure; A feasibility study. AU - MacDonald, Conor James. AU - Ross, Rose. AU - Houston, John Graeme. PY - 2020/4/10. Y1 - 2020/4/10. N2 - Strain measurements by US have been suggested as a method of assessing arterial elasticity prior to arterio venous fistula creation. This pilot study sought to develop an imaging protocol to measure strain in the brachial artery via velocity vector imaging (VVI) and determine if differences in strain could be observed between a healthy group and a group with end-stage renal disease (ESRD), and if VVI measurements were associated with arterio-venous fistula malfunction. 40 healthy volunteers and 33 patients with ESRD were included in this study. All participants underwent US assessment of brachial artery strain via VVI. Peak velocity, strain, strain-rate and velocity were assessed. Patients with and without AVF failure at 3-months were ...
Patients with end stage renal disease are at 18-20 times greater risk of dying from cardiovascular disease as the general population. Both traditional and non-traditional cardiovascular risk factors are thought to be important. Of the non-tradtional cardiovascular risk factors, creation of an arteriovenous fistula or graft for the purposes of a blood access for hemodialysis may contribute to an elevation in BNP and left ventricular hypertrophy - both factors that have been associated with an increased risk of mortality Prior to access creation and at one month and one year post access creation - samples for BNP will be collected Prior to access creation and at one year post access creation - echocardiography will be ...
Little is known about the targets and expectations of practicing nephrologists with regard to timing of preemptive AV access surgery and how these relate to actual observed practice patterns in clinical care. We administered a 8-question survey to assess nephrologists expectations for preemptive vascular access placement to 53 practicing nephrologists in California. We performed a retrospective chart review of 116 patients who underwent preemptive vascular access placement at a large academic medical center and examined progression to ESRD. According to our survey of nephrologists, most aimed to have preemptive vascular access created about 6 months prior to start of ESRD or when the chances of ESRD within the next year is two-thirds or greater. The estimated GFR level at which they believe match these conditions is approximately 18 ml/min/1.73 m2. Among the 116 patients with CKD who underwent preemptive vascular access creation, the mean estimated GFR at the time of access creation was 16.1 (6.8) ml
BioAssay record AID 698773 submitted by ChEMBL: Antithrombotic activity in Sprague-Dawley rat arteriovenous shunt model assessed as reduction of thrombus dry weight at 30 mg/kg, po qd for 5 consecutive days.
Vascular access dysfunction is the leading cause of morbidity amongst patients with end-stage renal disease (ESRD) and is a key performance indicator for haemodialysis service provision [1]. Complications of vascular access are responsible for over 20% of all hospitalisations in patients on haemodialysis and account for one-third of all inpatient renal bed use [2].. Autologous arteriovenous fistulae (AVFs) are the vascular access modality of choice [1,3] with fewer infective and thrombotic complications than the alternatives [1,4]: tunnelled central venous catheters (TCVCs) and prosthetic arteriovenous grafts (AVGs). The major limitations to native AVF usage are a 6 to 8 week "maturation" lag from creation to first cannulation and 30 to 50% early failure rate [5,6]. Unfortunately, due to a combination of late referral, primary access failure and acute presentation of renal failure, 40 to 50% of incident patients do not have a functioning AVF when they commence dialysis [3,7,8]. Given the ...
Hemodialysis requires frequent access to the patients blood stream (vascular system). Vascular access has been called the Achilles Heel of hemodialysis care. Hemodialysis vascular access procedures and associated costs come to $8,000-10,000 per patient per year. This amount represents approximately 25 percent of total ESRD medical costs. The most common problems are stenosis (narrowing of graft/blood vessel), infection, and thrombosis (clotting). At present, three types of vascular access are predominant: AV (arteriovenous) fistulas, AV grafts, and catheters. AV fistulas are surgically created by connecting a patients own artery and vein, usually in the forearm. AV fistulas have the lowest rate of complications, but take from several weeks to several months to mature, heal, and develop in size. Over time, an AV fistula becomes large enough to accommodate the needles required for hemodialysis. AV grafts are also created surgically, but use a synthetic blood vessel to connect the vein and ...
This study shows that in France, where the rate of predialysis AV access placement is relatively high, nonfunctional AV access at hemodialysis initiation is common and does not appear to have decreased over time. A substantial percentage of patients with nonfunctional AV access at first hemodialysis may never acquire a functional AV access which is associated with increased mortality risk. In contrast, the outcome of patients with a nonfunctional AV access converting to a functional one appears similar to that of those starting with a functional AV access. These findings have important implications for clinical practice and public health policies.. The 9% frequency of nonfunctional AV access at hemodialysis initiation in our study is of the same order of magnitude as that reported in Canada (9%) [4], but lower than in the US (18%) [2, 3]. Nevertheless, the relative weight of nonfunctional AV accesses among all those created predialysis was much lower in France than in North America. About 16% of ...
HealthTap: Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Korona on how long do you need to wait before you work out after av fistula placement: Absolutely up to the surgeon who placed the fistula.
Flow Forward Medical has announced the issuance of US Patents 9,155,827, 9,539,380 and 9,555,174 for its Arteriovenous Fistula Eligibility (AFE) system.. The 827 and 380 patents protect methods for using blood pump systems to dilate peripheral veins prior to vascular access site surgery.. This proprietary technology utilizes rapid blood flow with low pulsatility to provide highly favorable conditions for vein dilation and maturation.. Flow Forward is developing medical devices that enable the use of these methods for the creation of both arteriovenous fistula (AVF) and arteriovenous graft (AVG) vascular access sites. The 174 patent protects these AFE System devices.. The success of vascular access surgery is highly dependent on the diameter of the veins and arteries used to create access sites.. By providing larger veins prior to construction of an access site, these methods could potentially increase patient eligibility for AVF and AVG surgery, increase AVF maturation rates, reduce AVF ...
A very serious claim, the U.S. Department of Justice suspects that Angiograms (an X-ray test that uses a special dye and camera to take pictures of the blood flow in the AV Fistula) were unnecessarily performed on at least 10 Chronic Kidney Disease patients. DaVita said, "The company cannot predict, however, when this investigation will be resolved, its eventual outcome or scope, or its potential impact on the company.". Recommended Reading: Leading Large Dialysis Organization Under Federal Investigation Again After Kickbacks Settlement. Physicians often use this test to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, especially the AV Fistula when it relates to Chronic Kidney Disease patients who are conducting or set to begin Dialysis Treatments. Although an Angiogram is a minor procedure, it can cause complications such as bleeding or bruising at the site of the incision, infection at the incision site, and a mild to moderate allergic reaction to ...
May 24, 2017-Medtronic announced that the first patient has been enrolled in a study of the companys In.Pact AV Access drug-coated balloon (DCB) under a US Food and Drug Administration (FDA) investigational device exemption (IDE). The study will evaluate the safety and efficacy of the device as a treatment for failing arteriovenous (AV) fistulas in patients with end-stage renal disease.. According to Medtronic, the IDE study will assess the safety and efficacy of the In.Pact AV Access DCB for up to 2 years at approximately 30 sites in the United States, Japan, and New Zealand. The study will aim to enroll 330 patients with a 1:1 randomization to either treatment with the In.Pact AV access DCB or standard percutaneous transluminal angioplasty. The primary efficacy endpoint is patency of dialysis fistulas through 6 months, and the primary safety endpoint is serious adverse events through 30 days.. The first patient was treated by Jeffrey Hull, MD, Principal Investigator at Richmond Vascular ...
is committed to improving the health of patients with kidney and vascular diseases through the development of novel, first-in-class therapeutics. Proteons lead product candidate, vonapanitase, is an investigational drug intended to improve hemodialysis vascular access outcomes. Proteon is currently enrolling patients in PATENCY-2, a Phase 3 clinical trial evaluating vonapanitase in patients with chronic kidney disease (CKD) undergoing surgical creation of a radiocephalic arteriovenous fistula for hemodialysis. Proteon is also evaluating vonapanitase in a Phase 1 clinical trial in patients with peripheral artery disease (PAD). For more information, please visit www.proteontx.com.. Investor Contact ...
is committed to improving the health of patients with kidney and vascular diseases through the development of novel, first-in-class therapeutics. Proteons lead product candidate, vonapanitase, is an investigational drug intended to improve hemodialysis vascular access outcomes. Proteon is currently enrolling patients in PATENCY-2, a Phase 3 clinical trial evaluating vonapanitase in patients with chronic kidney disease (CKD) undergoing surgical creation of a radiocephalic arteriovenous fistula for hemodialysis. Proteon is also evaluating vonapanitase in a Phase 1 clinical trial in patients with peripheral artery disease (PAD). For more information, please visit www.proteontx.com.. Investor Contact ...
METHODS: We conducted a retrospective chart review of all adult patients, age ,18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process.. RESULTS: The 221 patients (56% female) in the study had median age of 66 years (interquartile range (IQR), 57-75) and were followed for a median of 1.26 years (IQR 0.6-1.68). At study entry, 81%had CKD stage 4 and 19% had CKD stage 5. By the end of study, 48 patients had initiated dialysis. Thirty-four of the patients started dialysis with a catheter (1 failed and 10 maturing AVFs), 9 with an AVF and 5 with an AVG. During the study period, 61 total AV accesses were placed (54 AVF and 7 AVG). A higher urinary protein/ creatinine ratio and a lower eGFR were associated with AV access placement and dialysis initiation. A greater number of nephrology visits were associated ...
News and information on minimally invasive vascular disease therapies, covering peripheral vascular disease, aneurysms, stroke, hypertension, dialysis access, and venous issues.
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HealthTap: Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Pak on ligation av fistula: Countless studies and decades of research have shown a clear advantage for patients who undergo hemodialysis through an av fistula. The second best is an av graft and all catheter-based modalities for hemodialysis are a distant third.
Can a pulmonary AV fistula be visualized on a coronary CTA angiography study? My cardiologist stated that a loud murmur was likely a pulmonary AV fistula. I had a coronary CTA angiography, which reve...
TY - JOUR. T1 - Balloon catheter looping technique for entry site angioplasty during endovascular management of thrombosed arteriovenous grafts by single access. AU - Park, Sung Il. AU - Kim, Il Jung. AU - Lee, Shin Jae. AU - Kim, Man Deuk. AU - Won, Jong Yun. AU - Lee, Do Yun. AU - Kang, Shin Wook. AU - Choi, Kyu Hun. PY - 2014/4. Y1 - 2014/4. N2 - Purpose: This study was designed to evaluate the feasibility of balloon catheter looping technique for angioplasty of entry site lesions of stenosis or thrombi that could not be aspirated during endovascular treatment of thrombosed arteriovenous grafts by single access. Methods: Balloon catheter looping technique was used for angioplasty of entry site lesions in 13 sessions of treatment of thrombosed arteriovenous grafts by single access in 11 patients (M:F = 7:4, mean age: 70.7 years, 9 brachio-axillary straight and 2 brachio-antecubital loop grafts) and were retrospectively evaluated. Middle equator of the graft was punctured and a 7F ...
access remains the weak point of the renal replacement therapy chain, generating a significant burden for the patient and the healthcare system. Vascular access morbidity, including maturation failure, dysfunction (requiring repetitive intervention, revision, angioplasty), infection or more severe complications (swelling of access limb, steal syndrome, heart failure) is the third most frequent cause of hospitalisation in haemodialysis patients. Despite the technical advances in vascular access surgery, prosthesis development, imaging and monitoring, the autologous arteriovenous fistula (AVF) developed more than fifty years ago by Cimino and Brescia remains the gold standard providing best outcomes in both the short and long term. It is recognised worldwide from evidence-based and shared clinical experience that the native AVF has the most cost-effective and cost-utility ratio in terms of vascular access and for these reasons should be considered as the first vascular access option in almost ...
Scope of the problem Hemodialysis vascular access is without question the lifeline for the more than 400,000 patients undergoing hemodialysis in the United States. Unfortunately, because of the high incidence of dialysis vascular access dysfunction, it is also the
This book describes the current status of vascular access for patients with end-stage renal failure who require dialysis. The book highlights controversial areas and problems and describes differences in practice in USA and Europe. Vascular Access is the Achilles heel of dialysis. In the United States and Europe in 1999 there were in access of 400,000 patients maintained on dialysis.
If you dont have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to https://my.wellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs. ...
A prospective study is running coordinated by the Mario Negri Institue in Italy. Preliminary results on 63 patients confirm the efficacy of this technology. Bode A, Caroli A, Huberts W, Planken N, Antiga L, Bosboom M, Remuzzi A, Tordoir J. Clinical study protocol for the ARCH project - computational modeling for improvement of outcome after vascular access creation. J Vasc Access. 2011 Oct-Dec;12(4):369-76. doi: 10.5301/JVA.2011.8382 ...
Arteriovenous (AV) fistula is a vascular access used to access the blood for hemodialysis treatment and can last for many years so those with chronic kidney disease who have advanced to end stage renal disease are able to receive dialysis.
Techniques are now being utilized in percutaneous fistula creation help to minimize and eliminate maturation failure, risk of infection, and scaring.
Dr. Greg Westin provides comprehensive care to patients with a variety of conditions involving the blood vessels. He graduated from Harvard College and completed his pre-medical studies at Columbia University. He received his medical degree from the University of California, Davis, where he was inducted into the Alpha Omega Alpha Honor Medical Society. He completely subspecialty training in vascular surgery at New York University (NYU).. Dr. Westin offers patients a wide variety of time-tested surgical treatments such as the surgical creation of access for hemodialysis (AV fistulae and grafts), femoropopliteal or femorotibial bypass, endovascular or open abdominal aortic aneurysm repair, anterior spine exposure, carotid endarterectomy, and all manner of catheter-based procedures for arteries and veins. In addition, he has experience with advanced new techniques currently only available in a few select centers, such as endovascular arteriovenous fistula creation, trans-carotid artery ...
PATIENTS: The subjects were transported by military en route care providers, in the combat theater during Operation Enduring Freedom (OEF) between January 2011 and March 2014. The authors reviewed 1,267 MEDEVAC records of US casualties and included 832 subjects that had vascular access attempts.. MAIN OUTCOME MEASURES: The outcome measures for this study were vascular access success rates, including intravenous (IV) and intraosseous (IO) attempts. Subjects were grouped by type of vascular access: None, peripheral intravenous (PIV), IO, and PIV + IO (combination of PIV and IO) and by vascular access (PIV or IO) success (No versus Yes). Survival rate, in-flight events, ventilator, intensive care and in hospital days, and 30-day outcomes were compared among groups.. STATISTICAL ANALYSIS: The authors used chisquare or Fishers exact tests to evaluate categorical variables. Analysis of variance (ANOVA) or Kruskal-Wallis tests were used for continuous variables.. RESULTS: Vascular access was attempted ...
My sisters kidneys shut down from strong meds used for a 3rd degree burn on her leg about 3+ weeks ago. She has a thing below her collar bone for dialysis for now, but the doctor thinks the kidneys will reverse. The question is, he wants her to come in, in 2 weeks to set up an appt for an AV Fistula in her arm ...
Background The contribution of multiple maintained non-functional arteriovenous grafts (AVGs) to the responsibility of chronic inflammation in chronic hemodialysis individuals is not very well studied. AVG and got considerably higher plasma log-CRP amounts compared with individuals without a earlier AVG (P= 0.036) whatever the current AV gain access to type. Utilizing a GLM we discovered that for every extra maintained thrombosed AVG plasma log-CRP log-IL-6 and TNF-alpha concentrations more than doubled by 0.30 mg/L (P= 0.011) 0.18 pg/mL (P= 0.046) and 0.72 pg/mL (P= 0.046) respectively following modification. Conclusions Hence the severe nature of swelling increases with the amount of maintained nonfunctional AVGs recommending that AVG build up may donate to the cardiovascular morbidity and mortality connected with chronic swelling in asymptomatic end-stage renal disease (ESRD) patients. Further study is usually indicated to determine whether patients with one or more thrombosed retained AVG ...
Right basilic vein transposition. End-stage renal disease with need for a long-term hemodialysis access. Excellent flow through fistula following the procedure.
A breakthrough initiative dedicated to improving care for people with chronic kidney disease by increasing AV fistula placement and use in suitable hemodialysis patients. Provides educational modules for planning, creation, and maintenance of vascular access planning for patients and physicians alike. Education modules are also available in Spanish.. ...
This ultrasound training video is designed to review the arterial and venous anatomy within the upper extremities, illustrate the advantages of AV fistulas over other indwelling devices, demonstrate complications of dialysis access procedures and state the sonographic criteria for stenosis and dysfunction.
This is a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. The authors observed significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt in patients aged ,65 years and in the first 2 years of follow-up in those aged ≥65 years. Only 2.3% of deaths to be access-related. In summary, predialysis fistula attempt maybe associated with a lower risk of mortality. However, the excess mortality observed in patients treated with catheters does not appear to be due to direct, access-related complications but is likely the result of residual confounding, unmeasured comorbidity, or treatment selection bias. The authors will be embarking on an RCT to follow these results.. ...
BREAKING NEWS*** Phase 1 of the trial has completed recruitement ahead of schedule. Congratulations to all participating centres and thank you to all the wonderful patients who agreed to take part ...
This study was designed to determine the proportion of access-related deaths in a retrospective cohort study of 2300 patients aged ≥18 years who initiated hemodialysis between 2004 and 2012 at five Canadian dialysis programs. There was significantly lower mortality in individuals who underwent a predialysis fistula attempt than in those without a predialysis fistula attempt in patients aged ,65 years (hazard ratio [HR], 0.49; 95% confidence interval [95% CI], 0.29 to 0.82) and in the first 2 years of follow-up in those aged ≥65 years (HR0-24 months, 0.60; 95% CI, 0.43 to 0.84; HR24+ months, 1.83; 95% CI, 1.25 to 2.67) with only 2.3% of deaths attributable to access. The authors convincingly suggest that the excess mortality observed in patients treated with catheters does not appear to be due to direct, access-related complications but is likely the result of residual confounding, unmeasured comorbidity, or treatment selection bias.. ...
PARK CITY, Utah, June 4, 2020 - Transit Scientific announced the FDA cleared the XO Score Percutaneous Transluminal Angioplasty (PTA) Scoring Sheath platform for use in iliac, ilio-femoral, popliteal, infra-popliteal, and renal arterial plus synthetic and/or native arteriovenous hemodialysis fistula.
In the following article, you will learn some information about arm veins and cephalic vein, including its uses, definition and problems that can occur with it. For those who are suffering from the disease in New York, the article may be of great help. Read on to get the information.
A new study describes how a minimally invasive system uses radiofrequency (RF) energy instead of open surgery to create hemodialysis arteriovenous fistulas (AVFs).. The TVA Medical (Austin, TX, USA) everlinQ endoAVF System utilizes two 6Fr magnetic catheters and a RF energy generator to create a consistent, hemodynamic AVF. The flexible magnetic catheters are first inserted into an artery and a vein in the arm. When in close proximity, the rare earth magnets in each catheter attract to each other, pulling the vessels together. After confirming alignment, a small burst of RF through the venous catheter opens an anastomosis between the artery and vein, creating the AVF. The catheters are then removed, leaving no surgical scar. (Read More). ...
SCVS 2018 Abstracts: Complete vs. Partial Excision of Infected Arteriovenous Grafts: Does Remnant Graft Material Impact Outcomes?
In another retrospective study that evaluated data over 6 years from 23,870 index transfemoral vascular access procedures from cross-matching the Eastern Danish Heart Registry with the Danis... more
Arteriovenous (AV) fistulas for hemodialysis access, constructed with the use of interposition grafts, are often complicated by intimal hyperplastic stenosis, mainly occurring at the venous anastomosis. In this study, mismatch in elastic properties a
Southern Vascular Clinic has years of experience in dialysis access management and dialysis access maintenance. Call our office in Lafayette - 337-534-4444.
Your Dialysis Access Team has made sure you are well prepared to leave the hospital. But we are always here to answer your questions, and address any concerns you have about what to watch for when you return home, staying healthy, guidelines for activities, your diet and nutrition, and maintaining your health.
A properly functioning hemodialysis arteriovenous (AV) access is essential for the hemodialysis patient. Unfortunately, venous stenosis and, to a lesser degree, arterial stenosis often develop, resulting in inadequate dialysis, extended treatment tim
Theres good news and theres bad news I would say. Bad news - My kidneys are failing Most people would be shocked an a little anxious for me. They would ask me questions on the different things in my blood like creatinine, urea and eGFR and things like that. But they would soon recover, and…
We have made it a priority to ensure that patients with Chronic Kidney Disease (CKD) receive safe and high quality dialysis access. Through a partnership with the De Souza Institute we can provide dialysis nurses in CKD programs across Ontario with centralized access to the Vascular Access Education Program. This program ensures that nurses and others who cannulate have access to high-quality education that is both comprehensive and consistent in delivering safe care. After completing the course, participants will learn to: ...
It can be frustratingly difficult to obtain hemostasis in bleeding dialysis fistulas. Here are some pearls to help you next time you see this patient!. ...
ABSTRACTObjective:To determine how frequent inflow stenosis is a contributing factor in the etiology of arteriovenous access-induced steal (AVAIS).Methods:A retrospective review of hemodialysis patients who underwent interventions from October 1998 to December 2011 for AVAIS was conducted at Mount S
Visit DocBios.com for information about Medford Dialysis Access P.C.. Find Phone & Address information, specialties, ratings and more
... Training Course provides participants a strong foundation to perform central and peripheral line techniques and approach in an emergency setting.
Often, we find ourselves or other clinicians come across barriers and obstructions to promoting and encouraging best clinical practices, especially in the vascular access realm. It may have even happened to us - trying to make important changes, based on strong clinical evidence, guidelines and recommendations - to be frequently informed that higher powers, not familiar with the best…
All around the world, vascular access specialists are pleading for a new tool in their toolboxes. More and more often, their skill with ultra-sound is
This is because the AV access bypasses the customary arteriole/capillary beds and establishes a direct high flow connection between the arterial and venous systems, which significantly affects blood flow. Find out more about how access flow can impact cardiac output and what you can do to protect your patients in this post.. ...
I have as a client, a bank that wants to setup a pc in their lobby for customers to be able to browse only the banks web site. I created a user named lobby and attempted to enter a proxy access rule to limit the lobby user to the one url of the banks site. None of the rules entered allowed the user access to the selected url(all sites were blocked). I tried port, Url and Application Proxy access Types and a selected destination of type DNS hostname. What am I missing. The
Does anyone know of the location of a good access procedure or ad-in for linear regression analysis (I dont mind paying if its is only abailable...
If you use anyone these AV client, you may wish to read the linked post: Avast (CVE-2017-5567)AVG (CVE-2017-5566)Avira (CVE-2017-64... | 26 replies | Antivirus
... such as an arteriovenous fistula) or innate (such as the arteriovenous shunt of a metarteriole); and it may be natural (such as ... Surgical[edit]. An example of surgical anastomosis occurs when a segment of intestine, blood vessel, or any other structure are ... Surgical anastamosis techniques include Linear Stapled Anastomosis,[3] Hand Sewn Anastomosis,[3] End-to-End Anastomosis (EEA).[ ... Studies have been performed comparing various anastomosis approaches taking into account surgical "time and cost, postoperative ...
... arteriovenous shunt, surgical MeSH E04.035.188 --- cerebrospinal fluid shunts MeSH E04.035.188.850 --- ventriculoperitoneal ... peritoneovenous shunt MeSH E04.035.760 --- portasystemic shunt, surgical MeSH E04.035.760.755 --- portacaval shunt, surgical ... peritoneovenous shunt MeSH E04.100.814.790 --- portasystemic shunt, surgical MeSH E04.100.814.790.790 --- portacaval shunt, ... arteriovenous shunt, surgical MeSH E04.100.814.200 --- blood vessel prosthesis implantation MeSH E04.100.814.300 --- cerebral ...
It is associated with amputees, haemodialysis (HD) patients with arteriovenous (AV) shunts, and patients with paralysed legs, ... Management includes compression therapy, wound care and surgical correction of AVM. Dapsone combined with leg elevation and ...
If the myelogram is positive, angiography is required to show the extent of malformation and the exact site of the shunt. ... Spinal arteriovenous malformations (AVMs, or angiomatous malformations) are congenital (from birth) abnormalities of blood ... presentation and endovascular surgical management". Semin Neurol. 22 (2): 123-32. doi:10.1055/s-2002-36535. PMID 12524557. ... A bruit (unusual blood sounds) may be heard overlying the spinal arteriovenous malformation. Very occasionally, nevus (moles) ...
Arteriovenous subpapillary plexus shunting also occurs. Persistent vasoconstriction at the precapillary sphincter creates a ... There is no standard medical or surgical treatment for acrocyanosis, and treatment, other than reassurance and avoidance of ...
... meningism and progressive neurological deficits due to acute or chronic ischaemia caused by arteriovenous shunting. As for the ... Patients with intracranial lesions have been treated with surgical intervention and in some cases, this procedure has been ... acute strokes or progressive neurological deficits due to acute or chronic ischaemia caused by arteriovenous shunting. The ... Malformations in arteriovenous connections and irregular functions in the veins may be distinguished by fluorescein ...
It often presents in infancy with cardiac failure because of extensive arteriovenous shunting within the lesion. It is the ... Surgical resection, radiotherapy, and chemotherapy have all been used to treat these masses, although studies on survival have ... Surgical resection, partial hepatectomy, and embolization of afferent vessels should be considered for severe cases. Low power ... indicating significant shunting, is seen on angiograms. Because most hemangioendotheliomas in infants sponanteously involute ...
He did his surgical training at Cook County Hospital in Chicago. Fabian Udekwu was the first fully certified cardiothoracic ... Traumatic aneurysms and arteriovenous fistulas in Nigeria. Clinical aspects of pulmonary and pleural carcinoma in Nigeria. ... Odeku, E. L.; Antia, A. U.; Udekwu, F. A. O. (1970). "Persistent ascites following infected ventriculoperitoneal shunt". W Afr ... Anyanwu, CH; Ude, AC; Swarup, AS; Umerah, BC; Udekwu, FA (August 1980). "Traumatic aneurysms and arteriovenous fistulas in ...
Larger arteriovenous shunts correlate with greater hemodynamic effects and earlier symptom onset; small arteriovenous shunts ... Even after surgical treatment, the mortality rate remains as high as 39.4%. Most cases occur during infancy when the mortality ... The heart failure is due to the size of the arteriovenous shunt that can steal 80% or more of the cardiac output, with large ... The Arteriovenous Malformation Study Group (June 10, 1999). "Arteriovenous Malformations of the Brain in Adults". New England ...
... an IH in the proliferative phase appears as a high flow soft-tissue mass usually without direct arteriovenous shunting. On MRI ... Surgical excision of hemangiomas is rarely indicated, and limited to lesions which fail medical therapy (or when it is ... In 2007, a paper from the Stanford Children's Surgical Laboratory revealed that localized soft tissue hypoxia coupled with ... may leave behind stretched skin or fibrofatty tissue that may be disfiguring or require future surgical correction. Areas of ...
... resulting in shunting of blood. This results in improperly oxygenated blood. (I67.1) Cerebral arteriovenous fistula, acquired ( ... For example, surgical treatment of fistulae in Crohn's disease can be effective, but if the Crohn's disease itself is not ... Coronary arteriovenous fistula, acquired (I28.0) Arteriovenous fistula of pulmonary vessels Pulmonary arteriovenous fistula: ... As a radical treatment for portal hypertension, surgical creation of a portacaval fistula produces an anastomosis between the ...
Vascular Anomalies: After correction of arterio-venous malformations with coiling, CBCT sensitively detects small infarcts in ... A dental cone beam scan offers invaluable information when it comes to the assessment and planning of surgical implants. The ... tissue that has been "sacrificed" during the procedure to prevent further shunting. The infarcted tissue appears as a small ... ability to combine 3 dimensional and weight bearing information which are of the utmost importance in diagnosis and surgical ...
If a source of bleeding can be identified (sources are frequently not found), then surgical correction of the bleeding source ... The chronic bleeding can come from many sources such as from an arteriovenous malformation or cavernous malformation, ... myxopapillary ependymoma of the spinal cord, from chronic subdural hematoma, from a ventricular shunt, or from chronic ...
Surgical Neurology International (SNI), its successor publication, was also headed by James I. Ausman, M.D., editor-in-chief. ... Faria MA Jr; O'Brien MS; Tindall GT (1980). "A technique for the evaluation of ventricular shunts using Amipaque and ... Schlachter LB, Fleischer AS, Faria MA Jr, Tindall GT (November 1980). "Multifocal Intracranial Arteriovenous Malformations". ... Faria completed his surgical internship at Shands Teaching Hospital at the University of Florida (1977-1978), and his ...
Deviations from the above described behavior can occur in arterialized hemangiomas or those containing arterio-venous shunts. ... Also they are successfully applied in the treatment of liver metastases, where surgical resection is contraindicated. They are ... the presence of arterio-arterial and arterio-venous shunts, lack or incompetence of arterial precapillary sphincter made up of ... Ablative therapies are considered curative treatments for HCC together with surgical resection and liver transplantation and ...
Results of surgical management. Ophthalmology. 1998;105(6):1015-23. 5. Canny C, Oliver G. Fluorescein angiographic findings in ... venous/venous shunting and abnormal branching patterns. 2,3,5 The staging of FEVR is similar to that of retinopathy of ... arteriovenous anastomoses and a V-shaped area of retinochoroidal degeneration. 4 Severe forms may present with ...
Intrapulmonary arteriovenous shunts are dormant capillaries within the lungs that become recruited when venous pressures become ... Common Surgical Diseases. (2nd ed.). 391-394 ISBN 978-0-387-75245-7. ... In general, a shunt may be within the heart or lungs, and cannot be corrected by administering oxygen alone. Shunting may occur ... Shunting also occurs by the smallest cardiac veins, which empty directly into the left ventricle. Physiological shunts, occur ...
It is used for managing fluid optimisation in high-risk surgical or critically ill patients. A physiologic optimization program ... ISBN 1-4160-2328-3. "Arteriovenous oxygen difference". Sports Medicine, Sports Science and Kinesiology. Net Industries. 2011. ... "Measurement of the ductal L-R shunt during extracorporeal membrane oxygenation in the lamb". Journal of Pediatric Surgery. 39 ( ... Electrical cardiometry monitors have shown promise in postoperative cardiac surgical patients, in both haemodynamicially stable ...
"VP shunts"). In pediatric practice, VP shunts are commonly placed in cases of congenital hydrocephalus. The most common ... developed surgical instruments that resemble surgical tools of today, gave accounts for creating aseptic environments using ... arteriovenous malformations, venous angiomas, cavernous angiomas, capillary telangectasias) of the brain and spinal cord ... Trephinations are crude surgical holes made through either scraping, cutting, or drilling away the layers of bone, and great ...
Low oxygen saturation and disturbed arterial blood gas readings support the proposed diagnosis by suggesting a pulmonary shunt ... Recurrent pulmonary oedema in hypertension due to bilateral renal artery stenosis: treatment by angioplasty or surgical ... Arteriovenous malformation. *Hantavirus pulmonary syndrome. *High altitude pulmonary edema (HAPE)[14][15] ...
As the child grows, so does the heart and the shunt may need to be revised in order to meet the body's requirements.[6][8][9] ... Awori, Mark Nelson; Mehta, Nikita P.; Mitema, Frederick O.; Kebba, Naomi (18 May 2017). "Optimal -Score Use in Surgical ... A shunt can be created between the aorta and the pulmonary artery to help increase blood flow to the lungs. ...
At the end of his nine years surgical training, he headed back to Salt Lake City. In 1979 Doctor DeVries went back to the ... November 27, 1986 ; "The New England Journal of Medicine" ; PMID 2945989 "Vein graft arteriovenous fistula for long-term venous ... "Physiologic and pathologic responses of the pulmonary circulation to high flow shunts." ; DeVries W.C., Anderson R.W. ; 1975 ... 1974 ; "Surgical Forum" ; PMID 4439171 "Changes in pulmonary capillary filtration and ventilatory dead space during exposure to ...
The flow of spinal fluid may be augmented by a shunt. Since this surgery usually involves the opening of the dura mater and the ... 1932: Van Houweninge Graftdijk was the first to report the surgical treatment of Chiari malformations. All patients died from ... "Acquired Chiari malformation Type I associated with a supratentorial arteriovenous malformation". Journal of Neurosurgery: ... Klekamp, J.; Batzdorf, U.; Samii, M.; Bothe, H. W. (1996). "The surgical treatment of Chiari I malformation". Acta ...
"VP shunts"). In pediatric practice, VP shunts are commonly placed in cases of congenital hydrocephalus. The most common ... developed surgical instruments that resemble surgical tools of today, gave accounts for creating aseptic environments using ... Vascular malformations (i.e. , arteriovenous malformations, venous angiomas, cavernous angiomas, capillary telangectasias) of ... Trephinations are crude surgical holes made through either scraping, cutting, or drilling away the layers of bone, and great ...
The first surgical intervention was performed by Norman Dott, who was a pupil of Harvey Cushing then working in Edinburgh. He ... SAH in a person known to have seizures is often diagnostic of a cerebral arteriovenous malformation. The combination of ... or occasionally a permanent shunt. Relief of hydrocephalus can lead to an enormous improvement in a person's condition. ... The main drawback of coiling is the possibility that the aneurysm will recur; this risk is extremely small in the surgical ...
Treatment varies between therapy and surgical intervention by the use of shunts.[citation needed] ... Clinical guideline 46: Venous thromboembolism (surgical). London, April 2007. *^ a b Geerts WH, Pineo GF, Heit JA, et al. ( ... In people with a "shunt" (a connection between the pulmonary and systemic circulation), either in the heart or in the lung, a ... Brunner, Lillian (2010). Brunner & Suddarth's textbook of medical-surgical nursing. Philadelphia: Wolters Kluwer Health/ ...
Arteriovenous Shunt Creation. *Axillary Lymph Node Dissection. *Bladder Surgery. *Breast Surgical Procedure ... Removal of Arteriovenous Shunt for Renal Dialysis. *Removal or Destruction of Rectal or Intestinal Tumor (incl. Colonoscopy, ...
Arteriovenous Shunt Creation. *Axillary Lymph Node Dissection. *Biopsy of Breast. *Breast Surgical Procedure ... Removal of Arteriovenous Shunt for Renal Dialysis. *Removal of Reproductive Organs (Hysterectomy, Oophorectomy, Salpingectomy, ...
Arteriovenous Shunt Creation. *Dialysis Access Procedures. *Vascular Duplex Ultrasonography and Plethysmography. *Vascular ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Removal of Reproductive Organs (Hysterectomy, Oophorectomy, Salpingectomy, ... Coastal Carolina Surgical Specialists is a multispecialty surgical group which brings world class surgical skill and technology ...
Arteriovenous Shunt Creation. *Axillary Lymph Node Dissection. *Biopsy of Breast. *Breast Surgical Procedure ...
Arteriovenous Fistula Repair. *Arteriovenous Shunt Creation. *Axillary Lymph Node Dissection. *Biopsy of Breast ... Breast Surgical Procedure. *Colectomy. *Colon and Rectal Surgery. *Destruction or Excision of Vaginal Lesions ...
Arteriovenous Shunt Creation. *Axillary Lymph Node Dissection. *Biopsy of Breast. *Bone Marrow Biopsy ... Breast Surgical Procedure. *Colectomy. *Colon and Rectal Surgery. *Dialysis Access Procedures. *Dressing and-or Debridement of ...
A graft, for example, an arterio-venous shunt graft, is provided, which in a first aspect of the subject invention, is formed ... Arteriovenous grafts and methods of implanting the same US4523920A (en) 1985-06-18. Surgical suction drain ... Arterio-venous shunt graft US11507797 Expired - Fee Related US7806848B2 (en) 2001-11-27. 2006-08-22. Arterio-venous shunt graft ... Implantable arteriovenous shunt device US7967769B2 (en) 2003-04-08. 2011-06-28. Rox Medical Inc.. Implantable arterio-venous ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Vascular Surgical Procedure. Background Check. Malpractice Claims not available. What is medical malpractice?. Healthgrades ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... University Surgical Vascular. 195 King Ave Ste 1. Athens. , GA. 30606. Get Directions. Phone ...
Revision of Arteriovenous Shunt for Renal Dialysis. *Thromboendarterectomy or Excision of Infected Graft ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Peripheral Vascular Surgical Procedures. *Peritoneal Dialysis. *Port Placements or Replacements. * ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Wilkes Regional Surgical Specialists. 1915 W Park Dr Ste 101 North Wilkesboro, NC 28659 ...
Revision of Arteriovenous Shunt for Renal Dialysis. *Varicose Vein Procedure. *Vascular Duplex Ultrasonography and ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Thromboendarterectomy or Excision of Infected Graft ... Vascular Surgical Procedure. Background Check. Malpractice Claims not available. What is medical malpractice?. Healthgrades ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Vascular Surgical Procedure. Background Check. 0 Malpractice Claims. What is medical malpractice?. No malpractice history found ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Renal Artery Arteriosclerotic Disease. *Revision of Arteriovenous Shunt for ... Peripheral Vascular Surgical Procedures. *Phlebitis and Thrombophlebitis. *Port Placements or Replacements. * ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Vascular Surgical Procedure. Background Check. 0. Malpractice Claims. What is medical malpractice?. No malpractice history ...
Removal of Arteriovenous Shunt for Renal Dialysis. *Revision of Arteriovenous Shunt for Renal Dialysis ... Vascular Surgical Procedure. Background Check. 0. Malpractice Claims. What is medical malpractice?. No malpractice history ...
Early application of an intermittent pneumatic compression device may assist in arteriovenous fistula dilation and are safe. ... Arteriovenous Shunt, Surgical* / adverse effects * Dilatation / adverse effects * Dilatation / instrumentation* * Equipment ... After arteriovenous fistula creation, a novel, intermittent pneumatic compression device (Fist Assist®) was applied 15 cm ... Among the patients who completed 1 month follow-up, 30 (n = 30) arteriovenous fistula patients were in the study arm to test ...
... by Doppler echocardiography in a neonate with a coexisting superior cavopulmonary shunt and an aortopulmonary shunt. During ... Arteriovenous Shunt, Surgical. Echocardiography, Doppler. Fatal Outcome. Heart Defects, Congenital / physiopathology, surgery ... by Doppler echocardiography in a neonate with a coexisting superior cavopulmonary shunt and an aortopulmonary shunt. During ...
Arteriovenous (AV) fistulas for hemodialysis access, constructed with the use of interposition grafts, are often complicated by ... Arteriovenous Shunt, Surgical*. Blood Vessel Prosthesis*. Catheters, Indwelling*. Elasticity. Female. Forearm / blood supply. ... Arteriovenous (AV) fistulas for hemodialysis access, constructed with the use of interposition grafts, are often complicated by ...
Between March 1998 and March 1999, 50 radiocephalic arteriovenous fistulas were constructed in 41 patients. Intraoperative ... Arteriovenous Shunt, Surgical* / instrumentation * Equipment Design * Female * Humans * Intraoperative Period * Male * Middle ... Between March 1998 and March 1999, 50 radiocephalic arteriovenous fistulas were constructed in 41 patients. Intraoperative ...
Arteriovenous Shunt, Surgical / adverse effects * Arteriovenous Shunt, Surgical / instrumentation* * California * Equipment ... Patient characteristics and surgical outcomes were collected. Comparisons were made between the 2 groups. ... Whether this translates into improved outcomes when used in the creation of arteriovenous fistulas (AVFs) remains unclear. We ... Background: Nonpenetrating titanium surgical clips (clips) offer a theoretical advantage of inducing less intimal hyperplasia ...
Arteriovenous shunt. US4762128 *. 9 Dic 1986. 9 Ago 1988. Advanced Surgical Intervention, Inc.. Method and apparatus for ... Shunt device 150 has been placed in a surgical or interventional procedure, or a combination of the two. In an open surgical ... Implantable arteriovenous shunt device. US20050107733 *. 7 Oct 2004. 19 May 2005. Faul John L.. Implantable arterio-venous ... Implantable arteriovenous shunt device. US20050277964 *. 13 Jun 2005. 15 Dic 2005. Rox Medical, Inc.. Methods for arterio- ...
  • I firmly believe that the risk of surgery should be less than the potential benefit before any surgical endeavor is undertaken. (dignityhealth.org)
  • After several unsuccessful attempts at sourcing funding to establish a modern surgical department from many organisations in the United States, United Kingdom, Scandinavia and through church aid, he was able to scrape together funding from the Enugu campus aided by the contributions of individual Nigerians to build the operating theater and buy the equipment needed to establish facilities for open heart surgery in Nigeria. (wikipedia.org)
  • Neurosurgery, or neurological surgery is the medical specialty concerned with the prevention, diagnosis, surgical treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. (wikipedia.org)
  • A graft, for example, an arterio-venous shunt graft, is provided, which in a first aspect of the subject invention, is formed with longitudinal ribs. (google.com)
  • To avoid repeated puncturing of blood vessels, a technique has been developed in the prior art, wherein a graft is implanted that acts as a shunt between an artery and a vein, such graft being aptly referred to as an arterio-venous (AV) shunt graft. (google.com)
  • Hybrid repair of ruptured infected anastomotic femoral pseudoaneurysms: Emergent stent-graft implantation and secondary surgical debridement. (biomedsearch.com)
  • This study aimed to evaluate the feasibility, safety, and efficacy of a hybrid repair for ruptured infected AFAPs consisted of percutaneous stent-graft deployment and second-stage surgical debridement. (biomedsearch.com)
  • METHODS: Between October 2004 and January 2008, 6 patients (3 female, mean age 65.8 +/- 11.4 years) with ruptured infected AFAPs were treated with emergent percutaneous stent-graft implantation and secondary surgical debridement. (biomedsearch.com)
  • Three patients had undergone a femoro-popliteal and 1 a femoro-tibial bypass for peripheral arterial disease, while 2 patients had a femoral arteriovenous graft (AVG) for hemodialysis access due to chronic renal failure. (biomedsearch.com)
  • Extensive surgical debridement along with pseudoaneurysm excision was accomplished successfully in all 6 patients 1-3 days after stent-graft placement under local anesthesia, without the need for extended vessel exposure for proximal and distal control. (biomedsearch.com)
  • CONCLUSION: Emergency stent-graft deployment, followed by secondary surgical debridement and long-term antimicrobial therapy is a viable alternative for ruptured infected AFAPs. (biomedsearch.com)
  • In order to improve the surface properties of small caliber vascular grafts or other surgical implants, Forskolin (or a derivative thereof) which is a power cAMP stimulating agent, is applied to the thrombogenic surfaces of the graft/implant. (google.es)
  • before implanting the synthetic vascular graft in the patient, applying locally to the graft 7B-acetoxy-8, 13-epoxy-1a-6, 9a-trihydroxylabd-14-en-11-one (Forskolin) or a derivative thereof. (google.es)
  • INTERVENTIONS All patients underwent cardiac catheterisation to exclude angiographically demonstrable venovenous collaterals followed by pulmonary perfusion scanning using 99m technetium ( 99m Tc) labelled albumen microspheres to quantify the intrapulmonary right to left shunt. (bmj.com)
  • MAIN OUTCOME MEASURE Percentage of intrapulmonary right to left shunt. (bmj.com)
  • Transcranial Doppler sonography with contrast indicated a right-to-left shunt, while on a follow-up CT scan lipiodol embolization was detected in both lungs. (biomedcentral.com)
  • Subsequently, an endovascular occlusion of several ipsilateral branches and ligation of the ipsilateral common carotid artery are necessary to create the pressure drop required for the "arterio-arterial" shunt in the model. (ajnr.org)
  • Characteristic elements of malignant circulation are vascular density, presence of vessels with irregular paths and size, some of them intercommunicating, some others blocked in the end with "glove finger" appearance, the presence of arterio-arterial and arterio-venous shunts, lack or incompetence of arterial precapillary sphincter made up of smooth musculatures. (wikipedia.org)
  • Arteries that directly communicate with veins bypass the capillary network (which has not yet developed) and thus creates a shunt. (wikipedia.org)
  • and the vascular nature of the lesion along with dilation of the aorta proximal to the origin of the celiac artery and a decrease in the diameter distally, indicating significant shunting, is seen on angiograms. (wikipedia.org)
  • During the Middle Ages in Arabia from 936 to 1013 AD, Al-Zahrawi performed surgical treatments of head injuries, skull fractures, spinal injuries, hydrocephalus, subdural effusions and headache. (wikipedia.org)
  • When the syndrome affects the brain, people can experience severe headaches, seizures, acute stroke, meningism and progressive neurological deficits due to acute or chronic ischaemia caused by arteriovenous shunting. (wikipedia.org)