Publications by authors named "Cui Tianlei"

Background: The feasibility of creating arteriovenous (AV) access in hemodialysis patients with superior vena cava occlusion (SVCO) is debated due to impaired blood return to the right atrium. However, collateral venous networks may offer an alternative solution, allowing for the creation of peripheral AV access. This study evaluates the outcomes of AV access construction in hemodialysis patients with SVCO.

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Article Synopsis
  • The study aimed to assess how effective percutaneous right atrial puncture and tunneled cuffed catheter insertion are for hemodialysis patients with superior vena cava occlusion (SVCO), and to explore options for patients with limited vascular access.
  • Methods involved enrolling SVCO patients and allowing them to choose between catheterization or establishing peripheral arteriovenous (AV) access, followed by specific procedures to restore vascular access based on imaging guidance.
  • Results showed that 45 patients participated, with 21 receiving catheters and 24 receiving AV access, and the researchers tracked demographic info, clinical outcomes, and complications related to each intervention.
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  • The study investigated the effectiveness and safety of using stents after treating superior vena cava stenosis in patients who are on long-term hemodialysis.
  • A total of 58 patients were analyzed, with a high success rate of 91.38% for the recanalization procedure, and a 98.1% success rate for stent placement.
  • However, complications occurred, including one serious case of stent displacement leading to cardiac issues, and the overall 2-year vascular access patency rate was found to be relatively low at 33.2%.
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Purpose: Maintenance hemodialysis patients who rely on tunneled-cuffed catheters (TCCs) often face difficulty in reinserting a new catheter when the original catheter has been extruded or removed. Potential pathological changes of vessel caused by long-term indwelling of a catheter may contribute to this predicament. The aim of this study was to report and evaluate a re-catheterization technique through the same exit site and tunnel for hemodialysis patients with TCC loss.

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Mispositioning in the azygos vein is a rare but hazardous complication of central venous catheterization. A patient was admitted for a dysfunctional hemodialysis tunneled cuffed catheter (TCC) placed in the azygos vein for 4 years. Computed tomography angiography revealed multiple sites of occlusion, including the superior vena cava (SVC), right and left innominate veins (IVs), and right femoral vein.

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Vascular calcification is common among hemodialysis patients. In this report, we presented a case of superior vena cava (SVC) stent migration during endovascular angioplasty in a 50-year-old female hemodialysis patient with severe SVC calcification. The stent migration was refractory to the deployment of a second anchor stent, which shortly resulted in pericardium tamponade and was successfully rescued by emergent thoracotomy.

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Objective: Tunneled-cuffed catheters (TCCs) are frequently used for establishing hemodialysis access for maintenance hemodialysis in older patients with exhausted resources of peripheral vessels. Fibrin sheath formation around the catheter is one of the most common complications of long-term use of indwelling catheter, which may cause the malfunction of the catheter. In this study, we intend to compare the prognosis of two catheter replacement methods, replacement and replacement through a fibrin sheath crevice, with both being assisted by balloon dilation, and to explore the optimal catheter replacement process.

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Objective: We analyzed the risk factors for hypotension in patients with hemodialysis-associated superior vena cava syndrome (SVCS) and effectiveness of endovascular intervention in hypotension related to SVCS.

Methods: This was a retrospective cohort study. A total of 194 maintenance hemodialysis patients diagnosed with SVCS who were admitted to the Department of Nephrology, West China Hospital of Sichuan University from January 2019 to December 2021 were selected and divided into a hypotension group and a nonhypotension group.

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Article Synopsis
  • Blood pressure variability (BPV) is linked to serious health risks such as cardiovascular issues, chronic kidney disease (CKD), and increased mortality, even if blood pressure levels are normal.
  • A systematic review evaluated 23 studies, showing that higher BPV correlates with faster CKD progression (HR: 1.21) and the development of end-stage renal disease (ESRD) (HR: 1.08).
  • Specific metrics of BPV, including high variation independent of mean, coefficient of variation, standard deviation, and average real variability, were found to be significant predictors of CKD progression.
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Objective: Central venous occlusion (CVO) refractory to endovascular angioplasty is a critical challenge that threatens hemodialysis vascular access. In the present study, we evaluated the efficacy and safety of tunneled, cuffed central venous catheter (tCVC) placement via percutaneous superior vena cava (SVC) puncture in patients with refractory CVO.

Methods: Patients requiring maintenance hemodialysis with refractory CVO who had undergone percutaneous SVC puncture and tCVC insertion at a university-affiliated hospital from January 2016 to June 2020 were included.

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Background: This umbrella review aims to consolidate evidence from systematic reviews and meta-analyses investigating the impact of the coronavirus disease-2019 (COVID-19) on kidney health, and the associations between kidney diseases and clinical outcomes in COVID-19 patients.

Methods: Five databases, namely, EMBASE, PubMed, Web of Science, the Cochrane Database of Systematic Reviews and Ovid Medline, were searched for meta-analyses and systematic reviews from January 1, 2020 to June 2, 2022. Two reviewers independently selected reviews, identified reviews for inclusion and extracted data.

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  • The study looked at a new method called endovascular AVF, which is used to help patients with kidney problems by creating a connection between blood vessels.
  • Researchers found that this method had a high success rate of 98%, and it worked almost as well as traditional surgery for creating blood vessel connections.
  • Although the endovascular AVF method seems safe, the researchers say more studies are needed to be completely sure about its effectiveness compared to other methods.
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Background: Central vein occlusion (CVO) is a serious problem in hemodialysis patients. There is an unsatisfactory result for refractory CVO by sharp recanalization alone. This study evaluated the efficacy and safety of blunt impingement followed by sharp recanalization for the treatment of CVO in hemodialysis patients.

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  • Multiple complete central venous occlusion (CVO) is a rare but serious issue for patients on hemodialysis, where percutaneous transluminal angioplasty (PTA) is the main treatment method, although long-segment occlusions can be particularly difficult to manage.
  • A 76-year-old male patient experienced significant swelling in his right arm due to CVO related to his hemodialysis access, leading to successful recanalization of multiple occluded veins through a groundbreaking bidirectional technique during surgery.
  • This case marks the first documented use of superior vena cava puncture in PTA for CVO, offering a new potential option for patients with limited treatment alternatives.
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Background: The prognostic value of blood pressure variability (BPV) in patients receiving hemodialysis is inconclusive. In this study, we aimed to assess the association between BPV and clinical outcomes in the hemodialysis population.

Methods: Pubmed/Medline, EMBASE, Ovid, the Cochrane Library, and the Web of Science databases were searched for relevant articles published until April 1, 2020.

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Hemodialysis is the lifeline of end-stage renal patients, and the correct choice of vascular access is vital to patients with vascular resource exhaustion. A 57-year-old female was admitted to the hospital due to catheter dysfunction. Color-doppler ultrasound (CDU) showed that the patient's inferior vena cava (IVC), right brachiocephalic vein, and long segment of the superior vena cava (SVC) were occluded.

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We present the case of a 53-year-old woman with a history of maintenance hemodialysis through arteriovenous fistula, CUFF catheter (cuffed tunneled catheter) and artificial vascular graft successively. Some signs of superior vena cava syndrome have presented including chronic edema in the face and left arm and varicose veins. Both CT (computed tomography) and angiography showed narrowing and occlusion in multiple veins, especially the right innominate vein, superior vena cava, inferior vena cava, left jugular vein, and bilateral common iliac veins.

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Rationale & Objective: Previous studies have illustrated the potential superiority of drug-coated balloons (DCBs) in maintaining patency after initial angioplasty for arteriovenous fistula (AVF) dysfunction due to stenosis. Our trial evaluated the efficacy and safety of DCBs for preventing fistula restenosis in Chinese hemodialysis patients.

Study Design: Multicenter, prospective, randomized, open-label, blinded end point, controlled trial.

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