Long-Term Outcomes of Fistula First Initiative in an Urban University Hospital-Is It Still Relevant?

Purpose: Dialysis access failure is a major cause of morbidity in patients with end-stage renal disease. The Fistula First Breakthrough Initiative (FFBI) dictates arteriovenous fistulae (AVFs) should be preferred over arteriovenous grafts (AVGs) as first line for surgically placed accesses. The purpose of this study was to compare patency rates of surgical dialysis accesses in our mature, urban population after the FFBI.

Mapping of superficial extremity veins: normal diameters and trends in a vascular patient-population.

Ultrasonic measurement of superficial extremity veins is a common procedure. To establish normal values for vein-size in a population of vascular patients and to assess if measurements remain unchanged over time, we analyzed a database with results of 28,130 measurements in 2420 separate saphenous and 3206 cephalic veins. Mean size of the great saphenous vein ranges from 2.

Reflux in foot veins is associated with venous toe and forefoot ulceration.

Objective: To determine the prevalence of foot vein incompetence in a group of patients with chronic venous insufficiency and to assess the association of this, with venous ulceration located on the forefoot.

Methods: A total of 20 consecutive patients (21 limbs) with active or healed venous ulceration was prospectively studied with duplex ultrasound of the superficial and plantar foot veins. In these, four extremities had venous ulceration involving the forefoot.

Improvement in the visualization of superficial arm veins being evaluated for access and bypass.

Objectives: Duplex ultrasound mapping of arm veins is being performed with increasing frequency. Unlike ultrasound testing in other areas, this has never been subjected to a gold standard invasive test to determine accuracy. Duplex mapping appears to have a good predictive value whenever large veins are demonstrated preoperatively, but its ability to accurately measure minimum-sized veins is unproven.

High-risk carotid endarterectomy: fact or fiction.

Objective: It has been proposed that patients whose conditions do not meet North American Symptomatic Carotid Endarterectomy Trial inclusion criteria or have anatomic risk factors constitute a "high-risk" group for carotid endarterectomy (CEA) and might be candidates for primary carotid angioplasty stenting. Our objective was to review a consecutive series of isolated CEAs, identify the number of such patients at high risk, and determine whether their operations were associated with increased complication rate.

Methods: Consecutive isolated CEAs performed between June 1996 and June 2001 were reviewed.