Impact of Duplex Ultrasound Surveillance Program on Patency of Prosthetic Arteriovenous Graft for Hemodialysis: A Single-Center Experience

Mauro, Raffaella; Pini, Rodolfo; Faggioli, Gianluca; Donati, Gabriele; Facchini, Maria Grazia; D'Amico, Rosalinda; Freyrie, Antonio; Gargiulo, Mauro; Stella, Andréa

doi:10.1016/j.avsg.2015.04.059

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…Additionally, the frequency of thrombus formation was significantly higher in the RD <1.85 mm group than in the RD >1.85 mm group. In previous studies (22, 23), AVG was used if the feeding artery and receiving vein had diameters of at least 2 mm and 4 mm, respectively. In AVFs, the diameter of the stenosis area was smaller than that of the feeding artery.…”

Section: Discussionmentioning

confidence: 99%

Duplex Ultrasound for the Prediction of Vascular Events Associated with Arteriovenous Fistulas in Hemodialysis Patients

Ishii

Suzuki²,

Nakayama³

et al. 2016

J Vasc Access

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Section: Discussionmentioning

confidence: 99%

Duplex Ultrasound for the Prediction of Vascular Events Associated with Arteriovenous Fistulas in Hemodialysis Patients

Ishii

Suzuki²,

Nakayama³

et al. 2016

J Vasc Access

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“…The initial placement of a T-CVC can pose challenges, such as the patient's clinical condition and the operator's expertise with the procedure [29,30], In these scenarios, the use of NT-CVCs is justified and, as our data confirm, does not result in a higher rate of short-term complications. However, in the absence of these barriers, the immediate use of a T-CVC is preferable.…”

Section: Discussionmentioning

confidence: 52%

Evaluating Short-Term Outcomes of Tunneled and Non-Tunneled Central Venous Catheters in Hemodialysis

Morisi,

Montani,

Ehode

et al. 2024

JCM

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Background: The necessity of using central venous catheters (CVCs) in hemodialysis, coupled with their associated complications, remains a critical concern in nephrology. This study aims to compare the short-term prognosis of tunneled (T-CVC) and non-tunneled (NT-CVC) CVCs in acute hemodialysis patients, specifically focusing on infection rates, malpositioning, and lumen thrombosis within the first three weeks post-insertion. Methods: A retrospective analysis was conducted on 176 CVCs placed between January and December 2023 at the Policlinico di Modena and the Ospedale Civile di Baggiovara. Patient demographics, CHA2DS2-VASc scores, and comorbid conditions were recorded at the time of catheter placement. Outcomes assessed included catheter-related infections, malpositioning, and lumen thrombosis. Statistical analyses, including Chi-square tests, Fisher’s exact tests, and Kaplan–Meier survival analysis, were performed to evaluate differences between T-CVCs and NT-CVCs. Results: The sample comprised 43% females with a mean age of 69.3 years (SD 13.9) and a mean CHADS-VASC score of 3.72 (SD 1.4). Hypertension (90%) was the most prevalent comorbidity. Of the 176 CVCs, 127 were T-CVCs and 49 were NT-CVCs. Infection rates were 3.15% for T-CVCs and 8.16% for NT-CVCs (p = 0.07). Malpositioning occurred in 0.79% of T-CVCs and 4.08% of NT-CVCs (p = 0.47). There was one case of lumen thrombosis in the NT-CVC group. Kaplan–Meier analysis indicated a significant divergence in infection-related catheter survival favoring T-CVCs after ten days (p = 0.034). Conclusions: While non-tunneled CVCs do not significantly alter short-term prognosis compared to tunneled CVCs, the latter show a better infection-related survival rate beyond ten days. Therefore, primary insertion of T-CVCs may be preferable when resources and clinical conditions permit, although NT-CVCs remain a viable option when immediate T-CVC insertion is challenging.

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“…Four of these concluded no additional benefit for use of noninvasive ultrasound surveillance techniques over traditional AV‐graft monitoring in AV‐graft outcomes, 9,10,15 but one study showed a tendency toward better results 8 . Mauro et al demonstrated better outcomes when using ultrasound surveillance techniques, but the limitation of this study was the small sample size and that evaluation of both groups was performed by two different operators, which may have skewed the findings further 16 …”

Section: Discussionmentioning

confidence: 76%

Effects of hemodialysis access surveillance on reducing risk of hemodialysis access thrombosis: A meta‐analysis of randomized studies

Ali

Mohamed

Baharani

2021

Hemodialysis International

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Introduction Vascular access thrombosis remains the Achilles Heel for many a hemodialysis patient. We performed a systematic review and meta‐analysis to assess the impact of monitoring vascular access blood flow on prediction and prevention of vascular access thrombosis. We hypothesized that monitoring vascular access blood flow has a pivotal role in lowering the risk of thrombosis and subsequent access failure. Methodology We conducted a systematic review in PubMed and EMBASE databases to identify randomized studies that have assessed the effect of hemodialysis access surveillance on the risk of thrombosis. A random‐effects model was used for the meta‐analysis. Subgroup analysis was performed among patients with arterio‐venous fistula (AV‐fistulas) and those with arterio‐venous graft (AV‐grafts). Results Ten randomized studies were included in the meta‐analysis. The total number of patients included in the analysis was 1430. On performing the random‐effects model among the included studies, hemodialysis access surveillance was associated with better outcomes (risk ratio = 0.73, 95% confidence interval ranges from 0.55 to 0.98). The analysis of the AV‐fistula group showed an estimated overall risk ratio of 0.55 (95% confidence interval ranges from 0.33 to 0.89) favoring access surveillance. However, in the AV‐grafts group, the estimated overall risk ratio was 0.92 (95% confidence interval ranges from 0.65 to 1.29) showing no additional benefit for access surveillance. Conclusion Hemodialysis access surveillance using access blood flow monitoring can reduce the risk of access thrombosis for patients with AV‐fistulas, but this is not the case with AV‐grafts.

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Impact of Duplex Ultrasound Surveillance Program on Patency of Prosthetic Arteriovenous Graft for Hemodialysis: A Single-Center Experience

Cited by 11 publications

References 12 publications

Duplex Ultrasound for the Prediction of Vascular Events Associated with Arteriovenous Fistulas in Hemodialysis Patients

Duplex Ultrasound for the Prediction of Vascular Events Associated with Arteriovenous Fistulas in Hemodialysis Patients

Evaluating Short-Term Outcomes of Tunneled and Non-Tunneled Central Venous Catheters in Hemodialysis

Effects of hemodialysis access surveillance on reducing risk of hemodialysis access thrombosis: A meta‐analysis of randomized studies

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