[Calcified Fibrin Sheath After Stuck Catheter Removal: Case Report and Literature Review].

The prevalence of central venous catheters (CVC) in hemodialysis patients is around 20-30%. In this scenario, complications related to the use of the CVC are commonly observed, requiring active management by nephrologists. These include infectious complications as well as those related to CVC malfunction.

Endovascular tools for vascular access stenosis: Flow-chart proposal.

Stenosis represents the most relevant arteriovenous fistula (AVF) pathology and can affects the entire conduit forming the fistula, from afferent artery to central venous vessels. Correction of vascular access stenosis significantly affects the survival and quality of life for end stage renal disease patients (ESRD) dependent on hemodialysis. Guidelines consider the procedure of percutaneous transluminal angioplasty (PTA) relevant for the primary treatment of these lesions with excellent results in restoring AVF immediately at the end of the procedure.

Distal AVF creation with marginal calcified radial artery: Multicentric experience of intraoperative intravascular lithotripsy.

Introduction: The first-choice vascular access to starting dialysis in patients with End Stage Renal Disease (ESRD) is autogenous distal arteriovenous-fistula (AVF) to spare vascular district avoiding proximal fistula complications. One of most significant exclusion criteria to create distal AVF is still now the presence of huge calcification of the feeding artery due to large numbers of early failure (EF) and failure in maturation (FTM). In recent years the possibility to use new devices able to deliver intravascular lithotripsy (IVL) to treat high calcified stenosis could be a possibility to recruit these marginal arteries to create distal AVF.

Percutaneous ecoguided endovascular lithotripsy to recruit failed-to-mature arteriovenous fistula due to completely calcified radial artery.

The first-choice vascular access for starting dialysis is autogenous distal forearm arteriovenous-fistula (AVF); the increasing demand to create more fistulas may lead to their creation in borderline vessels and, in this setting, the early failure (EF) and failure of maturation (FTM) remain the main issues. The size of vessels or preexisting stenotic lesions of artery or vein are no longer considered absolute exclusion criteria for the creation of distal AVF, but huge arterial calcification still represents an indication to create upper arm AVF. A novel approach to treat arterial calcifications is represented by intravascular lithotripsy (IVL).

[Triple stenosis of brachio-basilic arteriovenous fistula: percutaneous transluminal angioplasty utility, case report and literature review].

The major haemodialysis arteriovenous fistula (AVF) complication is stenotic disease. It is represented by a reduction of the arterial or venous caliper forming the AVF. Most frequently it is located in the juxta- anastomotic region of the venous segment.

CEUS-guided PTA on stenotic AVF: Morphological and functional point of view.

Background: Stenosis represents the main cause of hemodialysis fistula malfunction. The ultrasound-guided angioplasty with ecographic contrast (CEUS) could provide further advantages to the classical ultrasound guided method improving the morphological characterization of the stenosis and providing quantitative data with the creation of time intensity curves (TIC) collecting functional data comparable between pre and post procedure.

Methods: A total of 10 CEUS-guided angioplasties were performed on malfunctioning fistulas.

[Sonographic artifacts in nephrology].

The huge spreading of sonography in the field of nephrology led to the use of more performant equipment with construction of better quality images, but with an unfavorable signal/noise ratio, that bring to the generation of artifacts: false signals which creates images not corresponding to reality. Interaction between ultrasounds and biological structures generates a lot of physical phenomena: reflection, dispersion, absorption and diffraction; these elements create not only the images but also the artifacts. The artifacts, which don't correspond to anatomic reality, could be related to the extreme difference of acoustic impedance between the biological structures, or to an error in the settings of B-Mode and color-doppler functions.

[Parameters predicting arterious-venous fistula maturation in pre surgery vascular mapping].

Arterious-venous fistula (AVF) represents the first-choice vascular access for haemodialysis. Pre-surgery evaluation is mandatory to identify the appropriate vessels and to predict the success of AVF creation. Echo-color Doppler provides a wealth of morphological and functional values useful to create an optimal vascular access for haemodialysis.

The mechanisms of acute interstitial nephritis in the era of immune checkpoint inhibitors in melanoma.

Treatment with immune checkpoint inhibitors (ICIs) has improved the prognosis of patients with a number of types of cancer, but the frequent development of immune-related adverse effects (irAEs) can worsen the outcome. The most common irAEs involve the gastrointestinal, cutaneous, and endocrine systems, but nephrotoxicity, resulting from damage to the tubule-interstitial compartment, may occur in some patients. The early phases of acute interstitial nephritis (AIN) are characterized by systemic symptoms that indicate a poor clinical state as well as a mild deterioration of renal function.