The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. In the second part of the study, individual patients were followed prospectively during one year. This paper reports on several topics of the second part of the project, investigating complications of the VA related to centre, patient characteristics and dialysis techniques used. Complications most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Gradually more infections and flow problems were observed if the centre size and the patients/nurse ratio went up. Complication rate was not significantly influenced by age, gender, renal diagnosis, time on dialysis or medication used by the patient. In contrast, the number of vascular accesses in the past and interventions in the VA before first use resulted in an increased number of complications. Nurses have a key role in the prevention, manipulation and outcome of vascular access related complications.
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http://dx.doi.org/10.1111/j.1755-6686.2003.tb00301.x | DOI Listing |
J Vasc Access
January 2025
Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Background: Although conventional pre-operative venography can accurately delineate venous anatomy as an alternative to ultrasound for hemodialysis access planning, it may carry a risk of contrast-induced acute kidney injury (AKI) and progression of renal failure in chronic kidney disease (CKD) patients not yet on dialysis. Therefore, the objective of this study was to evaluate the safety and efficacy of pre-operative venograms in pre-end-stage kidney disease (ESKD) patients.
Methods: We performed a retrospective cohort study (2018-2022) of consecutive pre-ESKD patients who underwent staged bilateral venograms for preoperative vein mapping prior to hemodialysis access creation at a tertiary care medical center.
J Vasc Access
January 2025
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Background: Extracorporeal membrane oxygenation (ECMO) is a critical treatment for severe cardiopulmonary failure. However, traditional ECMO decannulation methods, such as manual compression and surgical repair, are associated with significant complications. This study evaluates suture-mediated closure devices, specifically Perclose ProGlide, as a potentially favorable decannulation strategy.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Introduction: In many countries, hemodialysis is still the most common method of renal replacement. Significant regional variations exist in creating and maintaining vascular access for hemodialysis. Therefore, analyzing national registries with vascular access data is essential for developing effective national treatment strategies.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Department of Health Sciences, University of Florence, Florence, Italy.
Background: Short peripheral catheter (SPC) placement is a routine invasive procedure in clinical settings that is crucial for administering fluids, medications, or blood components. Approximately 11% of adult patients arriving at the Emergency Department (ED) experience difficulties with intravenous access (DIVA), necessitating advanced techniques for successful placement. The Enhanced Adult DIVA (EA-DIVA) score serves as a validated tool to promptly identify patients with DIVA.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Department of Vascular and Endovascular Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia.
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