Background: In elderly and diabetic patients, arterial calcifications are prevalent and result in worse outcomes of arterio-venous fistulas (AVFs). Optimal ultrasound criteria for assessment of calcified arteries are unknown. We report our experience with ultrasound assessment of calcified arteries prior to placement of radio-cephalic (RC) AVFs.
Material And Methods: We included 85 patients in whom a RC-AVF placement was planned. Patients were divided according to the presence of radial artery calcifications into a calcified group (moderate/severe calcifications, = 18) and control group (no changes/mild atherosclerosis, = 67). Doppler ultrasound parameters were analyzed in the calcified group with focus on assessment of the artery, including grading of calcifications and Doppler measurements at rest and during reactive hyperemia (RH).
Results: In the calcified group mean patients' age was 72 ± 11 years, 72% were diabetics, mean resistance index (RI) during RH was 0.78 ± 0.09 (range 0.63-0.90). In 14 (78%) patients an AVF was successfully placed and in 12 it matured (67% maturation rate). A lower RI at rest was observed in the primary failure sub-group with high area under the ROC curve (0.89) and a cut-off value of 0.90 for RI. There was no difference in RI at RH between failed and matured AVFs. 1-year secondary patency was 66% and in eight patients with follow-up ultrasound available, blood flow was 350-1300 ml/min. For comparison, in the control group a radio-cephalic AVF was placed in all patients, primary failure rate was 6%, maturation rate 85% and 1-year secondary patency was 77%.
Conclusions: Our very limited experience suggests that successful RC-AVF placement and maturation with good 1-year patency rates is possible in patients with moderately/severely calcified arteries and RI during RH of up to 0.90.
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http://dx.doi.org/10.1177/11297298221143598 | DOI Listing |
J Endovasc Ther
January 2025
Angiology, HFR Fribourg, Hôpital Universitaire et Cantonal, Fribourg, Switzerland.
Purpose: Angioplasty of lower extremity arteries with calcification may result in flow-limiting dissection requiring bail-out stenting with unfavorable long-term outcomes. Vessel preparation prior to angioplasty may improve immediate results of the angioplasty and long-term patency. This prospective study assessed the 12-month outcomes of patients who underwent novel vessel preparation catheter, the FLEX Vessel Prep™ System (FLEX VP), prior to drug-coated balloon angioplasty (DCB-PTA).
View Article and Find Full Text PDFIntroduction: In 2015, Society for Vascular Surgery guidelines on claudication management were released spanning optimal medical management, procedural, and post-procedure recommendations. Uptake of guidelines and changes to clinical practice over time remain unknown. This study hypothesized that guideline aligned practice increased after guideline release.
View Article and Find Full Text PDFCase Rep Dent
January 2025
Oral Pathology, Faculty of Medicine and Health Sciences, Universidad Mayor, Santiago, Chile.
A calcifying odontogenic cyst (COC) is a cystic lesion originating from odontogenic epithelium, exhibiting ameloblastomatous features and containing focal accumulations of ghost cells. The standard treatment for COC typically involves enucleation followed by surgical curettage. However, if the cyst is large or closely associated with anatomical structures, decompression may be considered as a preliminary step before enucleation.
View Article and Find Full Text PDFAtheroscler Plus
March 2025
Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Background And Aims: Vitamin D binding protein (DBP) serves a dual function as a vitamin D carrier and actin scavenger. Free DBP is present in high concentrations in serum, while a smaller pool is bound to lipoproteins like HDL and VLDL. The role of DBP's interaction with lipoproteins remains unclear.
View Article and Find Full Text PDFJ Oral Biol Craniofac Res
December 2024
Division of Oral Radiology, School of Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil.
Purpose: This study aimed to assess the styloid process (TBSP) phenotype and to identify suggestive images of calcified atheromatous plaques (CAP) in panoramic radiographs of patients with primary hyperparathyroidism (PHPT) and post-surgical hypoparathyroidism (hypoPT). Additionally, it aimed to analyze the association between the bone mineral status of patients with parathyroid diseases and the radiographic findings.
Material And Methods: A cross-sectional case-control study was conducted with individuals diagnosed with PHPT (n = 25) and post-surgical hypoPT (n = 25).
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