Archive for the ‘Vascular Access’ Category

April 24, 2011

Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts

.   .   

This study was designed to assess the contribution of ASA alone after the recently published trial that showed extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts.  The results show that aspirin use caused a trend toward longer primary patency, but was not associated with prolongation of […]

Comments Off on Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts Posted in Vascular Access
February 8, 2011

Prevention of Dialysis Catheter Malfunction with Recombinant Tissue Plasminogen Activator

.   .   

In this trial, patients undergoing long-term hemodialysis were randomized to a catheter-locking regimen of heparin (5000 U per milliliter) three times per week or recombinant tissue plasminogen activator (rt-PA) (1 mg in each lumen) instead of heparin once per week. Catheter malfunction occurred almost twice as often in the heparin only group and catheter-related bacteremia […]

1 Comment Posted in Hemodialysis, Vascular Access
December 26, 2010

Routine Preoperative Vascular Ultrasound Improves Patency and Use of Arteriovenous Fistulas for Hemodialysis: A Randomized Trial

.   .   

In this randomized controlled trial, patients going for arteriovenous fistula creation were randomized to pre-operative review of vascular ultrasound versus routine care. The intervention group had a significantly lower rate of immediate access failure.  While primary AVF survival at 1 year was not statistically different, assisted primary AVF survival at 1 year was significantly better […]

Comments Off on Routine Preoperative Vascular Ultrasound Improves Patency and Use of Arteriovenous Fistulas for Hemodialysis: A Randomized Trial Posted in Vascular Access
November 1, 2010

Antiplatelet agents for the prevention of arteriovenous fistula and graft thrombosis: a meta analysis.

.   .   

This meta-analysis suggests that antiplatelet agents reduce the rate of thrombosis in arteriovenous fistulas but not arteriovenous grafts.

Comments Off on Antiplatelet agents for the prevention of arteriovenous fistula and graft thrombosis: a meta analysis. Posted in Vascular Access
May 1, 2010

Interventions for preventing infectious complications in haemodialysis patients with central venous catheters.

.   .   

This systematic review of strategies to prevent infectious complications of CVCs concludes that mupirocin ointment appears effective in reducing the risk of catheter-related bacteraemia.

1 Comment Posted in Vascular Access
March 23, 2010

Ultrasound-Guided Femoral Dialysis Access Placement: A Single-Center Randomized Trial

.   .   

While a small, single study trial, this RCT suggests that when inserting a femoral line for hemodialysis, ultrasound-guided insertion was superior and safer than the anatomical landmark-guided technique. Full text kindly provided by the American Society of Nephrology.

Comments Off on Ultrasound-Guided Femoral Dialysis Access Placement: A Single-Center Randomized Trial Posted in Hemodialysis, Vascular Access
February 12, 2010

Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts

.   .   

This important RCT concludes that in treatment of venous anastomotic stenosis of hemodialysis grafts, angioplasty plus placement of a stent provides better longer-term patency and freedom from repeat interventions than balloon angioplasty.

Comments Off on Stent Graft versus Balloon Angioplasty for Failing Dialysis-Access Grafts Posted in Hemodialysis, Vascular Access
August 20, 2009

Staphylococcus aureus Infections in Hemodialysis: What a Nephrologist Should Know

.   .   

This concise review provides a clinical perspective on Staphylococcus aureus infections in hemodialysis practice.  Free full text access kindly provided by the American Society of Nephrology.

Comments Off on Staphylococcus aureus Infections in Hemodialysis: What a Nephrologist Should Know Posted in Hemodialysis, Review, Vascular Access
July 10, 2009

Interventional Nephrology: Core Curriculum 2009

.   .   

This concise review from the American Journal of Kidney Disease Core Curriculum Series focusses on interventional nephrology.

Comments Off on Interventional Nephrology: Core Curriculum 2009 Posted in AJKD Core Curriculum, Review, Vascular Access
July 10, 2009

Mastery Learning of Temporary Hemodialysis Catheter Insertion by Nephrology Fellows Using Simulation Technology and Deliberate Practice

.   .   

This small study tested the impact of a formal educational program on the insertion of temporary hemodialysis catheters and revealed the intervention enhanced procedural competence.

1 Comment Posted in Educational Resource, Vascular Access
July 10, 2009

Treatment Guidelines for Dialysis Catheter–Related Bacteremia: An Update

.   .   

This commentary reviews and summarizes recommendations on managing infected hemodialysis catheters from Mermel et al: Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49:1-45, 2009.

1 Comment Posted in Vascular Access
July 10, 2009

Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter‐Related Infection: 2009 Update by the Infectious Diseases Society of America

.   .   

These IDSA guidelines replace the previous set last published in 2001. For the first time, these guidelines on the diagnosis and management of intravascular catheter‐related infection refers specifically to the management of tunnelled hemodialysis catheters.

Comments Off on Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter‐Related Infection: 2009 Update by the Infectious Diseases Society of America Posted in Vascular Access
June 10, 2009

Effect of dipyridamole plus aspirin on hemodialysis graft patency

.   .   

This randomized controlled trial provides evidence that treatment with dipyridamole plus aspirin had a modest effect in reducing the risk of stenosis and improving the duration of primary unassisted patency of newly created grafts. View the Accompanying editorial by C Lok Antiplatelet therapy and vascular-access patency. N Engl J Med. 2009 May 21;360(21):2240-2.

1 Comment Posted in Hemodialysis, Vascular Access