Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.
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http://dx.doi.org/10.1177/11297298211046827 | DOI Listing |
Nurs Crit Care
January 2025
Department of Nursing, Shanghai General Hospital, Shanghai, China.
This is a prospective observational study designed to develop an echocardiography-guided tip location program for central venous catheter (CVC) implantation, and to assess the feasibility and the accuracy of the program. First, a multidisciplinary expert committee designed an echocardiography-guided tip location program; then, a pilot prospective observational study was conducted to assess the feasibility of the program in a vascular access clinic in a tertiary hospital. A total of 186 patients participated in the study.
View Article and Find Full Text PDFRheumatol Int
January 2025
Department of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany.
Background: Diagnosis of Giant Cell Arteritis (GCA) and Polymyalgia rheumatica (PMR) may be challenging as many patients present with non-specific symptoms. Superficial cranial arteries are predilection sites of inflammatory affection. Ultrasound is typically the diagnostic tool of first choice supplementary to clinical and laboratory examination.
View Article and Find Full Text PDFKidney Med
January 2025
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.
View Article and Find Full Text PDFCureus
December 2024
Department of Medicine, Division of Endocrinology and Metabolism, King Abdulaziz Medical City, Riyadh, SAU.
Epithelioid hemangioendothelioma (EHE) is a rare form of vascular neoplasm that can manifest with various symptoms or be discovered incidentally in asymptomatic patients. In this report, we describe a case of a 56-year-old male who presented with progressive lower limb weakness over four years. The evaluation revealed severe hypophosphatemia, an inappropriately normal fibroblast growth factor 23 C-terminal (cFGF-23) level, and a 30 x 20 mm hypermetabolic right pleural mass, which was subsequently proven to be EHE.
View Article and Find Full Text PDFCureus
December 2024
Neurology, Palmetto General Hospital, Hialeah, USA.
The corpus callosum can reveal a "butterfly" pattern on imaging in various conditions, including glioblastoma, primary central nervous system lymphoma, tumefactive multiple sclerosis, and toxoplasmosis. Early differentiation among these conditions is crucial to avoid aggressive treatments. In one case, a 70-year-old woman with a history of multiple sclerosis experienced a neurological decline.
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