Stent graft treatment for hemodialysis access aneurysms

Shemesh, David; Goldin, Ilya; Zaghal, Ibrahim; Berelowitz, Daniel; Verstandig, Anthony; Olsha, Oded

doi:10.1016/j.jvs.2011.03.252

Cited by 57 publications

(55 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 Covered stent graft treatment for arteriovenous access aneurysms has been reported, but there are concerns regarding higher infectious complications. 13,14 We were reluctant to place stents in areas that would subsequently be cannulated due to concerns for stent fracture, thrombosis, and infection. In addition, bacterial colonization of aneurysms may occur if there is ulcerated skin and can subsequently result in infection of the stent graft.…”

Section: Discussionmentioning

confidence: 99%

Staple aneurysmorrhaphy to salvage autogenous arteriovenous fistulas with aneurysm-related complications

Tumbaga

Aka

et al. 2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

Our experience with staple aneurysmorrhaphy shows that it is an effective, safe, and durable procedure to preserve a functioning autogenous AVF with complicated aneurysmal degeneration. Key principles are to reduce the vein to normal adjacent diameter and to provide healthy skin coverage. The remodeled AVF has a low aneurysm recurrence rate and maintains the beneficial properties of superior patency and low infection. It is important to aggressively monitor for and treat proximal outflow venous stenoses to prevent aneurysm recurrence. The surgery can be done safely under local anesthesia in selected patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Staple aneurysmorrhaphy to salvage autogenous arteriovenous fistulas with aneurysm-related complications

Tumbaga

Aka

et al. 2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…Endovascular treatment with stent grafts in complicated access, in AVFs as well as in AVGs, aneurysms is a simple, safe and rapid ambulatory procedure that enables treatment of both the aneurysm and its accompanying draining vein stenosis. It enables continued cannulation of the existing access and avoids the use of central catheters [82,83] .…”

Section: Permanent Vamentioning

confidence: 99%

Vascular access today

Pantelias

Grapsa²

2012

WJN

View full text Add to dashboard Cite

The number of patients with chronic kidney disease requiring renal replacement therapy has increased worldwide. The most common replacement therapy is hemodialysis (HD). Vascular access (VA) has a key role for successful treatment. Despite the advances that have taken place in the field of the HD procedure, few things have changed with regards to VA in recent years. Arteriovenous fistula (AVF), polytetrafluoroethylene graft and the cuffed double lumen silicone catheter are the most common used for VA. In the long term, a number of complications may present and more than one VA is needed during the HD life. The most common complications for all of VA types are thrombosis, bleeding and infection, the most common cause of morbidity in these patients. It has been estimated that VA dysfunction is responsible for 20% of all hospitalizations. The annual cost of placing and looking after dialysis VA in the United States exceeds 1 billion dollars per year. A good functional access is also vital in order to deliver adequate HD therapy. It seems that the native AVF that Brescia and Cimino described in 1966 still remains the first choice for VA. The native forearm AVFs have the longest survival and require the fewest interventions. For this reason, the forearm AVF is the first choice, followed by the upper-arm AVF, the arteriovenous graft and the cuffed central venous catheter is the final choice. In conclusion, VA remains the most important issue for patients on HD and despite the technical improvements, a number of problems and complications have to be resolved.

show abstract

“…In a patient with active bleeding, treatment with an endovascular stent graft can also secure haemostasis. Although the reported one year patency rates of 87% [16] are comparable to the previously described remodelling techniques, criticism of stent graft insertion centre on the increased costs of the procedure and lack of utility in specifi c subgroups of patients. For instance, situations where the endovascular approach is not suitable include patients with aneurysms close to the anastomosis, steal syndrome and large aneurysms lacking an adequate landing zone for sealing the stent graft.…”

Section: Endovascular Techniquesmentioning

confidence: 55%

“…Furthermore, increased venous pressure may also result from stenosis within the central venous system and hasten aneurysm formation. Central venous stenosis typically results from extended central venous catheterisation and previously published studies suggest a broad range of incidence between 13% and 100% [15][16][17][18][19][20]. Imaging of the central venous system by fi stulography or ultrasound is not routine however, and potentially explains the wide incidence rates reported.…”

Section: Prevalence and Aetiologymentioning

confidence: 99%

Contemporary management of arteriovenous hemodialysis fistula aneurysms

2018

View full text Add to dashboard Cite

SOUHRNÚvod: Aneurysma arteriovenózní fi stuly vzniká až u 60 % hemodialyzovaných pacientů. Často jde o asymptomatickou komplikaci, avšak s možným rizikem rozvoje závažných komplikací. Existuje řada chirurgických a endovaskulárních technik léčby, ale jasná klinická doporučení, kdy a jak intervenovat, chybějí. Autoři popisují klinický obraz, indikace k léčbě a současné možnosti léčby aneurysmatu arteriovenózní fi stuly. Metodika: Nesystematický přehled publikované literatury uvedených databází: MEDLINE, ScienceDirect, Scopus a Cochrane Database of Systematic Reviews. Do hodnocení byly zahrnuty publikace týkající se aneurysmatu arteriovenózní fi stuly a terapeutických možností od ledna 1973 do června 2016. Z hodnocení byly vyřazeny práce týkající se aneurysmatu a pseudoaneurysmatu protetických graftů. Výsledky: Aneurysma arteriovenózní fi stuly je defi nováno jako dilatace všech tří vrstev cévní stěny a průměrem větším než 18 mm. Indikace k léčbě jsou: bolestivost, riziko krvácení a neadekvátní průtok (nízký/vysoký). Samotný průměr aneurysmatu, stejně jako kosmetické důvody, by neměly být indikací k léčbě. Nejčastěji využívané terapeutické modality léčby aneurysma arteriovenózní fi stuly jsou: resekce s interpozicí, remodelační techniky a implantace stentgraftu. I když bylo publikováno několik léčebných metod, v současné době neexistuje publikace srovnávající jednotlivé léčebné techniky. Závěr: Asymptomatické aneurysma arteriovenózní fi stuly má být léčeno konzervativně s pravidelným sledováním. Vzhledem k absenci dostatečných důkazů neexistuje jasná strategie léčby pro aneurysma arteriovenózní fi stuly vyžadující intervenci. U symptomatického aneurysmatu, zejména s vysokým rizikem krvácení, by měla být co nejdříve indikována terapie.ABSTRACT Introduction: Aneurysms develop in up to 60% of patients with an arteriovenous fi stula. Frequently arteriovenous fi stula aneurysms are asymptomatic with the presence of symptoms potentially heralding the development a signifi cant complication. A range of surgical and endovascular techniques are available to manage arteriovenous fi stula aneurysms but clinical guidelines regarding the appropriate application of each approach are lacking. This review will examine the presentation, indications for treatment and management options for arteriovenous fi stula aneurysms. Methods: A non-systematic review of published literature in the following databases was performed: MEDLINE, ScienceDirect, Scopus and the Cochrane Database of Systematic Reviews. Publications relating to arteriovenous fi stula aneurysms and treatment options between January 1973 and June 2016 were considered for inclusion. Articles pertaining to aneurysms and pseudoaneurysms of prosthetic arteriovenous access sites were excluded. The literature search was supplemented by a review of the author's experience. Results: Arteriovenous fi stula aneurysms are defi ned by an expansion of the intimal, medial and adventitial layers of the vessel wall to a diameter of more than 18 mm. Treatment of arteriovenous fi stula aneur...

show abstract

Stent graft treatment for hemodialysis access aneurysms

Cited by 57 publications

References 19 publications

Staple aneurysmorrhaphy to salvage autogenous arteriovenous fistulas with aneurysm-related complications

Staple aneurysmorrhaphy to salvage autogenous arteriovenous fistulas with aneurysm-related complications

Vascular access today

Contemporary management of arteriovenous hemodialysis fistula aneurysms

Contact Info

Product

Resources

About