Secondary Interventions in Patients With Implantable Cardiac Devices and Ipsilateral Arteriovenous Access

Abstract

stenosis >50% was found in 0% and 33% (P ¼ .0474) of patients in the infraclavicular and supraclavicular approaches, respectively. Infraclavicular thoracic outlet decompression was associated with fewer postoperative symptoms, 0 (0%) vs 8 (53.3%; P ¼ .0022), and infraclavicular thoracic outlet decompression demonstrated superior patency, 15 (100%) vs 8 (66.7%; P ¼ .0282). In addition, there was a trend toward fewer reinterventions in the infraclavicular group, 0.27 6 0.8 vs 0.87 6 1.5 (P ¼ .1984). Mean combined follow-up was 8.47 6 10.8 months. Conclusions: Infraclavicular thoracic outlet decompression for the surgical management of VTOS was associated with fewer postoperative symptoms and superior axillosubclavian vein patency compared with the supraclavicular approach. Prospective analysis is warranted to determine long-term outcomes after infraclavicular decompression.

Midterm results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System, technical recommendations, and an algorithm for maintenance

“…Existence of an ipsilateral catheter is not a contraindication to creation of a pAVF, and this has recently been validated by Kim et al, 28 showing no effect on maturation rates and early failure of AVFs in patients with tunneled catheters on the same side as the access. 29 Need for repeated interventions either for maturation problems or for access maintenance remains a major problem for AVF patients, with significant cost and quality of life implications. 30 Our results demonstrate that pAVFs have less need for reinterventions through the outflow draining veins and cannulation sites, whereas maturation rates were excellent.…”