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Indian J Pediatr 2022 Jun 24. Epub 2022 Jun 24.

Department of Pediatric Intensive Care, Balcali Hospital, Medical Faculty Cukurova University, Adana, Turkey.

Objective: To evaluate the safety and functionality of the transhepatic approach as an alternative route for central venous catheterization in pediatric patients with chronic critical illness.

Methods: The study included data of 12 chronic critically ill pediatric patients who underwent central venous catheterization with transhepatic approach. The indications, procedure details, mean patency time, and catheter-related complications were retrospectively analyzed. Read More

J Med Vasc 2022 Apr 24;47(2):87-93. Epub 2022 May 24.

Nephrology, dialysis and transplantation department, Hassan II University Hospital, Fez, Morocco; Laboratory of Epidemiology and Health Science Research (ERESS), Faculty of Medicine-Fez, Sidi-Mohammed-Ben-Abdellah University, Fez, Morocco. Electronic address:

Objective: Tunneled central venous catheters (TCVC) are a good alternative in case that an arteriovenous fistula (AVF) cannot be made, awaiting maturation or during unscheduled hemodialysis. We report the experience in placing these catheters by nephrologists and establish the various indications and complications in hemodialysis patients. We also relate the lifespan of tunneled catheters in our series. Read More

Artif Organs 2022 Jul 24;46(7):1439-1442. Epub 2022 May 24.

Nephrology Department, Indiana University Health Arnett, Lafayette, Indiana, USA.

Dual-lumen "acute" central venous catheters (CVC) for dialysis were developed in the 1970s and tunneled "chronic" CVC in the 1980s. Fibrous sheathing of these catheters diminished the patency after weeks to months of use. Double catheters like Canaud/Tesio worked better and longer than single body catheters but were tedious to place. Read More

J Vasc Access 2022 May 16:11297298221096520. Epub 2022 May 16.

Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.

Background: Tunneled central venous catheters (tCVC) exchange may be difficult in some situations. We retrospectively report our preliminary experience of a novel extra-catheter guide wire technique for exchange of dysfunctional tCVC.

Materials And Methods: Retrospectively analyze the demographics, treatment details and outcomes data of 39 patients received tCVC exchange from January 2018 to January 2019. Read More

Am J Infect Control 2022 May 13. Epub 2022 May 13.

Hospital das Clínicas, Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, MG, Brazil; Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address:

Rationale: To understand the risk factors for catheter-related infection during treatment of pediatric cancer is essential to implement measures to prevent its occurrence.

Background: We performed a comprehensive systematic review of the literature with meta-analysis to identify and synthesize the main risk factors for catheter-related infection in children undergoing oncological treatment.

Methods: Systematic searches were conducted in Medline, Embase, Lilacs, and BVS (Biblioteca Virtual em Saúde) until January 2022, following PRISMA guidelines. Read More

J Nephrol 2022 Jun 14;35(5):1515-1519. Epub 2022 May 14.

Centro de Nefrologia da Santa Casa de Belo Horizonte, R. Piauí, 420 - Santa Efigênia, Belo Horizonte, MG, 30150-320, Brazil.

Introduction: Hemodialysis is the most used dialysis modality in Brazil for the treatment of end-stage chronic kidney disease and severe acute kidney injury. Non-tunneled, short-term, double-lumen catheters allow immediate vascular access in patients without a definitive vascular access for dialysis treatment. Implantation is performed using the Seldinger technique, traditionally based on anatomical landmarks or with puncture under direct visualization by ultrasonography. Read More

J Vasc Access 2022 May 11:11297298221095769. Epub 2022 May 11.

Department of Statistics and Data Science, Faculty of Science, National University of Singapore, Singapore.

Background: Creation and maintenance of dialysis vascular access (VA) is a major component of healthcare resource utilization and cost for patients newly started on hemodialysis (HD). Different VA format arises due to patient acceptance of anticipatory care versus late preparation, and clinical characteristics. This study reviews the clinical journey and resource utilization required for different VA formats in the first year of HD. Read More

Tomography 2022 04 3;8(2):1033-1040. Epub 2022 Apr 3.

Department of Interventional Radiology Oregon Health and Sciences University, Portland, OR 97239, USA.

Background: The ideal central venous catheter (CVC) tip position placement is controversial, and CVCs do not remain in a fixed position after placement. This study evaluates both patient and procedural factors which may influence CVC tip migration and subsequent catheter dysfunction.

Materials And Methods: This study evaluates CVC placements at a single institution. Read More

J Vasc Access 2022 Apr 20:11297298221092745. Epub 2022 Apr 20.

Department Blood Purification Center of Hainan Provincial Hospital, Hainan Medical University Affiliated Hainan Hospital, China.

Objective: To explore the feasibility and safety of Guidewire-Balloon Entrapment Technique (GBET) for the recanalization of thoracic central vein occlusions (TCVOs) in hemodialysis patients.

Methods: A retrospective observational study was conducted using data from 28 patients who required the establishment or maintenance of hemodialysis access and were treated with GBET for the recanalization of right-sided TCVOs from January 2017 to April 2021. Of the patients, 27 required tunneled cuffed catheter (TCC) placement or exchange, and 1 had an outflow tract occlusion of the Brescia-Cimino radio cephalic arteriovenous fistula (AVF). Read More

Kidney360 2021 12 7;2(12):1953-1959. Epub 2021 Oct 7.

Department of Renal Medicine, Liverpool Hospital, Liverpool, Australia.

Background: Long-term arteriovenous fistula (AVF) survival has been shown to be adversely affected by the presence of previous tunneled vascular catheters (TVC). We analyzed the effect of previous TVCs and their location (ipsilateral versus contralateral) on the successful function of upper-limb AVFs in the first 12 months after creation.

Methods: We retrospectively reviewed clinical data on patients' first upper-limb AVFs, created between January 2013 and December 2017. Read More

J Vasc Surg Venous Lymphat Disord 2022 Mar 30. Epub 2022 Mar 30.

Vascular Surgery Service, Department of Surgery, Woodlands Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address:

Objective: Ensuring reliable central venous access with the fewest complications is vital for cancer patients receiving chemotherapy. A systematic review and network meta-analysis was conducted to compare the safety, quality of life, and cost-effectiveness of different types of central venous access devices (CVADs) for patients receiving chemotherapy.

Methods: The PubMed, EMBASE, and Cochrane databases were searched from inception to August 20, 2021 for randomized controlled trials comparing the various CVADs (ie, nontunneled central venous catheters [CVCs], peripherally inserted CVCs [PICCs], totally implantable venous access ports [TIVAPs], and tunneled CVCs). Read More

J Vasc Access 2022 Mar 27:11297298221085421. Epub 2022 Mar 27.

Department of Nephrology & Hypertension, Glickman Urological & Kidney Institute, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA.

Central vein catheter is a convenient and preferred vascular access for blood purification therapy in intensive care unit. Utilizing ultrasound to access the central vein is considered standard of care. However, critically ill patients can pose challenges while acquiring an optimal ultrasound image. Read More

Saudi J Kidney Dis Transpl 2021 Jul-Aug;32(4):1073-1088

Nephrology and Dialysis Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.

There is a paucity of data on epidemiology along with an incomplete registry of end-stage kidney disease (ESKD), nephrologist workforce, and variability among the countries of Gulf Cooperation Council (GCC). The study is an observation, descriptive study which aimed to describe current ESKD burden, nephrologist density, and kidney care infrastructure in GCC. Responses to a questionnaire-based survey obtained from representatives of the Nephrology Societies of GCC countries were analyzed. Read More

Sci Rep 2022 01 10;12(1):306. Epub 2022 Jan 10.

Department of Nephrology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan.

Some hemodialysis patients are not suitable for creation of an arteriovenous fistula (AVF) or arteriovenous graft (AVG). However, they can receive a tunneled cuffed central venous catheter (tcCVC), but this carries risks of infection and mortality. We aimed to evaluate the safety and effectiveness of brachial artery transposition (BAT) versus those of tcCVC. Read More

Vasc Endovascular Surg 2022 Apr 27;56(3):253-257. Epub 2021 Dec 27.

Department of Cardiovascular Surgery Clinic, 290817Elazığ Fethi Sekin City Hospital, Elazig, Turkey.

Objective: This study aimed to evaluate the rate of asymptomatic bacterial infection of tunneled dialysis catheters (TDCs) removed due to maturation of native arteriovenous fistula (nAVF) or catheter dysfunction in hemodialysis patients with no clinically apparent infection.

Materials And Methods: A total of 229 patients (43.2% [n = 99] female and 56. Read More

JACC Case Rep 2021 Dec 1;3(17):1816-1821. Epub 2021 Dec 1.

DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.

We describe an 81-year-old man with end-stage renal disease and central venous occlusion who was referred for dialysis access creation. This case illustrates a novel percutaneous image fusion-guided recanalization of an occluded right subclavian vein and brachiocephalic vein stent in a patient with limited remaining dialysis access sites. (). Read More

J Surg Res 2021 11 21;267:712-714. Epub 2021 Aug 21.

Department of Paediatrics, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Surgery, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia. Electronic address:

Kidney Int Rep 2021 Dec 11;6(12):2958-2968. Epub 2021 Oct 11.

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.

Hemodialysis-central venous catheter (HD-CVC) insertion is a most often performed procedure, with approximately 80% of patients with end-stage kidney disease in the United States initiating kidney replacement therapy through a HD-CVC. Certain adverse events arising from HD-CVC placement, including catheter-related bloodstream infections (CR-BSIs), thrombosis, and central vein stenosis, can complicate the clinical course of patients and lead to considerable financial impact on the health care system. Medical professionals with different training backgrounds are responsible for performing this procedure, and therefore, comprehensive operator guidelines are crucial to improve the success rate of HD-CVC insertion and prevent complications. Read More

J Vasc Access 2021 Dec 10:11297298211048061. Epub 2021 Dec 10.

Division of Interventional Radiology, Duke University Medical Center, Durham, NC, USA.

Background: The purpose of this study was to assess the feasibility and outcomes of recanalization and subsequent HeRO graft outflow component insertion across stent interstices in patients with an otherwise abandoned upper extremity.

Methods: Over a 10-year period, 15 patients underwent central venous recanalization by interventional radiology across the interstices of one or more occluded stents for the purpose of subsequent HeRO graft creation. A tunneled central venous catheter was left across the stent and occlusions with tip in right atrium. Read More

Semin Dial 2022 01 29;35(1):86-92. Epub 2021 Nov 29.

Department of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Naval Medical University, Shanghai, China.

Hemodialysis is the most widely used renal replacement therapy for end-stage renal disease patients. Exhausted vascular access due to repeated indwelling central venous catheters is becoming a challenging clinical problem, which also contributes to reduced survival of the hemodialysis patients. Lack of conventional peripheral and central venous access mandates the use of alternative strategies. Read More

J Vasc Access 2021 Sep 23:11297298211046751. Epub 2021 Sep 23.

UNC Kidney Center, Chapel Hill, NC, USA.

Background: Although tunneled dialysis catheters (TDC) are far from ideal, they still represent the main form of vascular access for most patients beginning dialysis. Catheters are easy to place and allow patients instant access to dialysis, but regardless of these benefits, catheters are associated with a high incidence of significant complications like bloodstream infections, central venous stenosis, thrombosis, and dysfunction. In the present study, we aim to describe and characterize a swine model of catheter dysfunction and bloodstream infection, that recreates the clinical scenario, to help to serve as a platform to develop therapeutic innovations for this important clinical problem. Read More

J Thromb Thrombolysis 2022 Feb 22;53(2):257-263. Epub 2021 Sep 22.

The Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Health System, 2800 Plymouth Road, Building 16 #432W, Ann Arbor, MI, 48109, USA.

Venous thromboembolism (VTE) is an important complication of coronavirus disease 2019 (COVID-19). To date, few studies have described vascular access device use and VTE risk in this cohort. To examine the use of vascular access devices and incidence of VTE in patients hospitalized with COVID-19. Read More

J Vasc Access 2021 Aug 21:11297298211039633. Epub 2021 Aug 21.

Department of Nephrology and Hypertension, Cleveland Clinic Foundation, Cleveland, OH, USA.

One of the most challenging aspects of providing end-stage kidney disease care is to achieve adequate long-term access to the bloodstream to support hemodialysis (HD) therapy. Although upper extremity arteriovenous fistula remains the vascular access of choice for patients on HD, complications such as central venous stenosis, access thrombosis, or exhaustion of suitable access sites in the upper extremity, ultimately result in pursuing vascular access creation in the lower extremity. The current review focuses on the indications, contraindications, and clinically relevant practical procedural tips to successfully place a tunneled femoral dialysis catheter. Read More

Int J Environ Res Public Health 2021 07 16;18(14). Epub 2021 Jul 16.

Maimonides Institute of Biomedical Research of Cordoba, 5000 Córdoba, Spain.

Older age and comorbidities in hemodialysis patients determines the use of tunneled catheters as vascular access despite their reported clinical and mortality disadvantages. This prospective matched study analyzes the impact of permanent catheters on inflammation and mortality in hemodialysis patients; We studied 108 patients, 54 with AV-fistula (AVF) and 54 with indwelling hemodialysis catheters (HDC) matched by sex, age, diabetes and time under renal-replacement therapy comparing dialysis efficacy, inflammation and micro-inflammation parameters as well as mortality. Cox-regression analysis was applied to determine predictors of mortality, HDC patients presented higher C-reactive-protein (CRP) blood levels and percentage of pro-inflammatory lymphocytes CD14+/CD16+ with worse dialysis-efficacy parameters. Read More

J Vasc Bras 2020 14;19:e20190142. Epub 2020 Sep 14.

Associação de Integração Social de Itajubá - AISI, Hospital de Clínicas de Itajubá - HCI, Departamento de Cirurgia Vascular e Endovascular, Itajubá, MG, Brasil.

Background: Short-term (ST) and long-term tunneled (LTT) central venous catheters for hemodialysis (CVCH) are critical for hemodialysis therapy. However, few studies have been conducted in Brazil to investigate the incidence of complications with these two types of catheters.

Objectives: To analyze complications and duration of CVCH in a hemodialysis center at a teaching hospital. Read More

Br J Nurs 2021 Jul;30(14):S4-S13

Chair in Mental Health, School of Health and Social Care, Edinburgh Napier University.

Background: Vascular access devices (VADs) are essential for delivery of intravenous therapies. There are notable gaps in the literature regarding a focus on patient experience and meaning-making related to living with a VAD, specifically a central venous access device (CVAD).

Aims: To explore how patients make sense of living with a CVAD. Read More

Cureus 2021 Jun 2;13(6):e15398. Epub 2021 Jun 2.

Dialysis Unit, Fresenius Medical Care, Burzaco, ARG.

Introduction:  Oxidative stress (OS) is ubiquitous in chronic kidney disease (CKD) and is exacerbated by hemodialysis (HD). OS is also associated with anemia, malnutrition, and cardiovascular (CV) disease and is an independent predictor of mortality and morbidity in patients undergoing HD. HD vascular access (VA) types are strongly correlated with CKD patient outcomes. Read More

J Vasc Access 2021 Jun 19:11297298211026825. Epub 2021 Jun 19.

Fondazione Policlinico Universitario "A.Gemelli", Rome, Italy.

Background: Chest-to-arm (CTA) tunneling has been described recently as a technique that allows an optimal exit site at mid-arm even in chronically ill patients with complex clinical issues and challenging problems of vascular access.

Method: We adopted CTA tunneling in oncologic and in non-oncologic patients, in totally implanted and in external devices, for both medium and long-term intravenous treatments. We report our experience with 60 cases of CTA tunneling: 19 patients requiring a totally implantable device, who had bilateral contraindication to venous access at the arm and bilateral contraindication to placement of the pocket in the infra-clavicular area; 41 patients requiring an external central venous catheter, who had bilateral contraindication to insertion of peripherally inserted central catheters or femoral catheters, as well as contraindication to an exit site in the infraclavicular area. Read More

SAGE Open Med 2021 28;9:20503121211019889. Epub 2021 May 28.

Department of Nephrology and Internal Medicine, Institute of Medical Sciences, University of Opole, Opole, Poland.

Introduction: The majority of the end-stage renal disease patients begin hemodialysis with the central tunneled catheter as a permanent or bridge vascular access. The procedure of central tunneled catheter insertion can be complicated by exit site bleeding, prolonged tunnel healing, and infection. The study aimed at evaluating whether the catheter exit site wound closing with a single-suture method is equally effective as the double suture method, which is most frequently applied. Read More

J Vasc Access 2021 Jun 6:11297298211023288. Epub 2021 Jun 6.

Department of Surgery, Saiwaicho Memorial Hospital, Okayama, Japan.

A superficialized artery as a blood-drawing route could be an option for vascular access (VA) in hemodialysis patients with cardiac failure, vessel damage, steal syndrome, and venous hypertension, and it could be a secondary VA option in those with repetitive vascular access troubles, routinely requiring a blood-returning venous route. The brachial artery is preferably used for superficialization due to the benefit of its appropriate diameter for cannulation, procedural ease of surgery under local anesthesia, and usable subcutaneous vein for blood-returning route in the upper limb. The superficial femoral artery (SFA) has also been reported as a candidate for arterial transposition; however, its subcutaneous transposition could have difficulties in requiring general anesthesia and securing blood-inflow-venous routes. Read More