In this study, we present two cases of sudden deaths of people with end-stage kidney with arteriovenous fistulas for long-term hemodialysis treatment. This procedure is associated with a number of known complications. While stenosis, thrombosis, and infection are well known, lethal hemorrhage from arteriovenous fistula is much less commonly encountered. Inspection of the bodies at the scene of the death by a medical examiner suggested that the deaths were due to exsanguination. Autopsies revealed visible defects on the front wall of the arteriovenous fistulas. Microscopic examination showed wall necrosis with infiltration of various inflammatory cells. Deaths were due to exsanguination from the ulcerated arteriovenous fistulas in patients with chronic renal failure. Further investigation revealed that complications in the area around the arteriovenous fistulas were known and were being treated until a sudden rupture of the vessels and hemorrhage from the arteriovenous fistulas resulted in the deaths.
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http://dx.doi.org/10.1111/1556-4029.13730 | DOI Listing |
J Neurointerv Surg
January 2025
Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: We aim to share our experience of transradial access (TRA) for cerebral angiography and intervention in five patients ranging from 6 days to 7 months of age.
Methods: In this institutional review board-approved, retrospective case series, we reviewed all patients who underwent TRA for cerebral angiography with and without intervention. We describe three techniques for radial artery cannulation, namely: (1) bareback; (2) with a micropuncture sheath; and (3) with an intravenous catheter.
J Neurointerv Surg
January 2025
Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
J Neurointerv Surg
January 2025
Diagnostic and Therapeutic Neuroradiology, Hôpital Purpan, Toulouse, France.
Background And Purpose: Embolization is the first-line treatment for dural arteriovenous fistulas (dAVF). The precipitating hydrophobic injectable liquid (PHIL) embolic agent is a non-adhesive copolymer with specific features and endovascular behavior. This study assessed its safety and efficacy in a prospective real-life cohort.
View Article and Find Full Text PDFFront Physiol
December 2024
Department of Nephrology, People's Hospital of Zhengzhou University, Zhengzhou, China.
The assessment of vascular accessibility in patients undergoing hemodialysis is predominantly reliant on manual inspection, a method that is associated with several limitations. In this study, we propose an alternative approach by recording the acoustic signals produced by the arteriovenous fistula (AVF) and employing deep learning techniques to analyze these sounds as an objective complement to traditional AVF evaluation methods. Auscultation sounds were collected from 800 patients, with each recording lasting between 24 and 30 s.
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