Physical examination (PE) of arteriovenous access remains of high clinical value and continues to be recommended by leading societies and guidelines. PE is easy to learn and perform. Once learned, examiners can provide a comprehensive arteriovenous (AV) access examination in 20 to 30 seconds. Therefore, we continue to advocate that AV access PE should be part of the training for all dialysis care providers. Similarly, ultrasound can provide important AV access evaluation and provide key information. It is relatively cheap and can be readily available at the bed side. Additionally, it is well accepted by patients, as it is not expected to be associated with pain or discomfort during the examination. We present in this review the key components of PE, signs and symptoms of AV access dysfunction, and the role of ultrasound in AV access evaluation as a complementary tool to PE.
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http://dx.doi.org/10.1055/s-0041-1740946 | DOI Listing |
Objectives: Femoral vein transposition (tFV) is a complex procedure that provides high patency rates for patients with exhausted upper-limb vascular access. Traditionally, the procedure involves a long single incision in the thigh to harvest the femoral vein, but this approach is associated with increased risks of local complications such as infections and haematomas. Skip incisions have shown to lower complication rates and shorten maturation times.
View Article and Find Full Text PDFNPJ Digit Med
December 2024
Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA.
Where adopted, Autonomous artificial Intelligence (AI) for Diabetic Retinal Disease (DRD) resolves longstanding racial, ethnic, and socioeconomic disparities, but AI adoption bias persists. This preregistered trial determined sensitivity and specificity of a previously FDA authorized AI, improved to compensate for lower contrast and smaller imaged area of a widely adopted, lower cost, handheld fundus camera (RetinaVue700, Baxter Healthcare, Deerfield, IL) to identify DRD in participants with diabetes without known DRD, in primary care. In 626 participants (1252 eyes) 50.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Sheffield Kidney Institute, Northern General Hospital, Herries Road, Sheffield, United Kingdom, S5 7AU.
Obesity is growing in Haemodialysis population. Few scholars report variable effect of increased Body Mass Index (BMI) on native fistula. Reports on obesity effect on Arteriovenous Graft (AVG) patency are lacking.
View Article and Find Full Text PDFJ Ultrason
December 2024
Department of Nephrology, General Hospital of Mexico Dr. Eduardo Liceaga, Mexico City, Mexico.
Aim: Our objective was to determine the factors associated with the successful maturation of arteriovenous fistulas during hemodialysis.
Material And Methods: This prospective study included patients treated with hemodialysis and predialysis patients. Clinical, biochemical, sociodemographic, vascular ultrasound mapping, flow-mediated dilatation, and surgical factors were analyzed.
Plast Reconstr Surg Glob Open
December 2024
Division of Nephrology, Department of Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE.
Background: More than 65% of patients with end-stage renal disease (ESRD) use arteriovenous fistulas (AVFs) for hemodialysis. The increasing incidence of comorbid ESRD and obesity (body mass index, >35 kg/m) precludes patients from kidney transplantation, resulting in a need for long-term, durable AVF access. Compared with traditional superficialization techniques for overlying adiposity, liposuction is minimally invasive and well-tolerated, allowing for earlier fistula use with lower complications.
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