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Gabriels JK, Schaller RD, Koss E, Rutkin BJ, Carrillo RG, Epstein LM. Lead management in patients undergoing percutaneous tricuspid valve replacement or repair: a 'heart team' approach. Europace 2023; 25:euad300. [PMID: 37772978 PMCID: PMC10629975 DOI: 10.1093/europace/euad300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 09/30/2023] Open
Abstract
Clinically significant tricuspid regurgitation (TR) has historically been managed with either medical therapy or surgical interventions. More recently, percutaneous trans-catheter tricuspid valve (TV) replacement and tricuspid trans-catheter edge-to-edge repair have emerged as alternative treatment modalities. Patients with cardiac implantable electronic devices (CIEDs) have an increased incidence of TR. Severe TR in this population can occur for multiple reasons but most often results from the interactions between the CIED lead and the TV apparatus. Management decisions in patients with CIED leads and clinically significant TR, who are undergoing evaluation for a percutaneous TV intervention, need careful consideration as a trans-venous lead extraction (TLE) may both worsen and improve TR severity. Furthermore, given the potential risks of 'jailing' a CIED lead at the time of a percutaneous TV intervention (lead fracture and risk of subsequent infections), consideration should be given to performing a TLE prior to a percutaneous TV intervention. The purpose of this 'state-of-the-art' review is to provide an overview of the causes of TR in patients with CIEDs, discuss the available therapeutic options for patients with TR and CIED leads, and advocate for including a lead management specialist as a member of the 'heart team' when making treatment decisions in patients TR and CIED leads.
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Affiliation(s)
- James K Gabriels
- Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY, USA
| | - Robert D Schaller
- Electrophysiology Section, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Elana Koss
- Department of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY, USA
| | - Bruce J Rutkin
- Department of Cardiovascular and Thoracic Surgery, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY, USA
| | | | - Laurence M Epstein
- Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, 300 Community Drive, Manhasset, NY, USA
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Guarracini F, Preda A, Bonvicini E, Coser A, Martin M, Quintarelli S, Gigli L, Baroni M, Vargiu S, Varrenti M, Forleo GB, Mazzone P, Bonmassari R, Marini M, Droghetti A. Subcutaneous Implantable Cardioverter Defibrillator: A Contemporary Overview. Life (Basel) 2023; 13:1652. [PMID: 37629509 PMCID: PMC10455445 DOI: 10.3390/life13081652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
The difference between subcutaneous implantable cardioverter defibrillators (S-ICDs) and transvenous ICDs (TV-ICDs) concerns a whole extra thoracic implantation, including a defibrillator coil and pulse generator, without endovascular components. The improved safety profile has allowed the S-ICD to be rapidly taken up, especially among younger patients. Reports of its role in different cardiac diseases at high risk of SCD such as hypertrophic and arrhythmic cardiomyopathies, as well as channelopathies, is increasing. S-ICDs show comparable efficacy, reliability, and safety outcomes compared to TV-ICD. However, some technical issues (i.e., the inability to perform anti-bradycardia pacing) strongly limit the employment of S-ICDs. Therefore, it still remains only an alternative to the traditional ICD thus far. This review aims to provide a contemporary overview of the role of S-ICDs compared to TV-ICDs in clinical practice, including technical aspects regarding device manufacture and implantation techniques. Newer outlooks and future perspectives of S-ICDs are also brought up to date.
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Affiliation(s)
- Fabrizio Guarracini
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Alberto Preda
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Eleonora Bonvicini
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Alessio Coser
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Marta Martin
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Silvia Quintarelli
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Lorenzo Gigli
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Matteo Baroni
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Sara Vargiu
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Marisa Varrenti
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Giovanni Battista Forleo
- Department of Thoracic Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy;
| | - Patrizio Mazzone
- Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.P.); (L.G.); (M.B.); (S.V.); (M.V.); (P.M.)
| | - Roberto Bonmassari
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Massimiliano Marini
- Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy; (E.B.); (A.C.); (M.M.); (S.Q.); (R.B.); (M.M.)
| | - Andrea Droghetti
- Cardiology Unit, Luigi Sacco University Hospital, 20157 Milan, Italy;
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Czajkowski M, Polewczyk A, Jacheć W, Nowosielecka D, Tułecki Ł, Stefańczyk P, Kutarski A. How does a CIED presence influence chances and safety of haemodialysis access? Conclusions from over 3000 thoracic venografies. Clin Physiol Funct Imaging 2023; 43:47-57. [PMID: 36251514 PMCID: PMC10092861 DOI: 10.1111/cpf.12792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/20/2022] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
Patients requiring temporal or permanent catheter or arterio-venous fistula (AVF) for haemodialysis may be in challenging situation, if they are cardiovascular implantable electronic devices (CIED) carriers. MATERIALS AND METHODS The authors analysed preoperative venogrphies of 3100 patients referred for transvenous lead extraction for a possible chance of safe haemodialysis catheter (HC) implantation or proper AVF function. RESULTS A chance of safe catheter implantation parallel to existing leads reaches 68.8% ipsilaterally to CIED. Contraindications for implantation have been found in less than 2% of cases contralaterally. Ipsilaterally proper AVF function chance has been found in 50.3% of the cases and almost 98% contralaterally. A bilateral chest electrodes location require the special attention. Abandoned lead, lead burden, bilateral leads, additional lead implantation or abandonment, and implant duration may have a significant influence on HC insertion or proper function of arteriovenous fistula. CONCLUSION (1) Obstruction of prominent thoracic veins is a frequent finding in CIED carriers and may impede or disable implantation haemodialysis accesses. (2) Implantation of temporary or permanent HC may be questionable ipsilaterally to the CIED in 31.2% and contralaterally in 2.0% of patients. Proper function of AVF is uncertain in 49.7% ipsilaterally and 2.1% contralaterally to CIED. (3) Pacing history and leads dwell time influence chances of success haemodialysis access even on the free-from CIED chest side. (4) Proper venous flow evaluation seems to be valuable in CIED carriers before an attempt of haemodialysis access formation, even contralaterally.
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Affiliation(s)
- Marek Czajkowski
- Department of Cardiac Surgery, Medical University of Lublin, Lublin, Poland
| | - Anna Polewczyk
- Department of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Jacheć
- 2nd Department of Cardiology, Silesian Medical University , Zabrze, Poland
| | - Dorota Nowosielecka
- Department of Cardiology Surgery, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | - Łukasz Tułecki
- Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | - Paweł Stefańczyk
- Department of Cardiology Surgery, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | - Andrzej Kutarski
- Department of Cardiology, Medical University of Lublin, Lublin, Poland
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Shaikh A, Albalas A, Desiraju B, Dwyer A, Haddad N, Almehmi A. The role of stents in hemodialysis vascular access. J Vasc Access 2023; 24:107-116. [PMID: 33993804 PMCID: PMC10896277 DOI: 10.1177/11297298211015069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Vascular access is the Achilles' heel of dialysis therapy among patient with end stage kidney disease. The development of neointimal hyperplasia and subsequent stenosis is common in vascular access and is associated with significant morbidity. Percutaneous transluminal angioplasty using balloon inflation was the standard therapy of these lesions. However, the balloon-based approaches were associated with poor vascular access patency rate necessitating new inventions. It is within this context that different types of stents were developed in order to improve the overall dialysis vascular access functionality. In this article, we review the available literature regarding the use of stents in treating dialysis vascular access stenotic lesions. Further, we review the major clinical trials of stent use in different anatomic locations and in different clinical scenarios.
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Affiliation(s)
- Aisha Shaikh
- Department of Medicine, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Alian Albalas
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brinda Desiraju
- Department of Medicine, SUNY Downstate School of Medicine, Brooklyn, NY, USA
| | - Amy Dwyer
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Nabil Haddad
- Department of Medicine, The Ohio State University Medical Center, Columbus, OH, USA
| | - Ammar Almehmi
- Department of Medicine and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Prevention and Management of Cardiac Implantable Electronic Device Infections: State-of-the-Art and Future Directions. Heart Lung Circ 2022; 31:1482-1492. [PMID: 35989213 DOI: 10.1016/j.hlc.2022.06.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/09/2022] [Accepted: 06/19/2022] [Indexed: 11/23/2022]
Abstract
Cardiac implantable electronic device (CIED) infection is an increasingly common complication of device therapy. CIED infection confers significant patient morbidity and health care expenditure, hence it is essential that clinicians recognise the contemporary strategies for predicting, reducing and treating these events. Recent technological advances-in particular, the development of antimicrobial envelopes, leadless devices and validated risk scores-present decision-makers with novel strategies for managing this expanding patient population. This review summarises the key issues facing CIED patients and their physicians, and explores the supporting evidence for the latest therapeutic developments in this field.
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Leo M, Sharp AJ, Gala ABE, Pope MTB, Betts TR. Transvenous or subcutaneous implantable cardioverter defibrillator: a review to aid decision-making. J Interv Card Electrophysiol 2022:10.1007/s10840-022-01299-6. [PMID: 35835888 DOI: 10.1007/s10840-022-01299-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/06/2022] [Indexed: 01/08/2023]
Abstract
The implantable cardioverter-defibrillator (ICD) is a proven treatment for preventing sudden cardiac death. Transvenous leads are associated with significant mortality and morbidity, and the subcutaneous ICD (S-ICD) addresses this. However, it is not without limitations, in particular the absence of anti-tachycardia pacing. The decision of which device is most suitable for an individual patient is often complex. Here, we review the relative merits and weaknesses of both the transvenous and S-ICD. We summarise the available evidence for each device in particular patient cohorts, namely: ischaemic and non-ischaemic cardiomyopathy, idiopathic ventricular fibrillation, Brugada syndrome, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, and hypertrophic cardiomyopathy.
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Affiliation(s)
- Milena Leo
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alexander J Sharp
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Andre Briosa E Gala
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Michael T B Pope
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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7
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Iatrogenic Infective Endocarditis in Hemodialysis Patients: A Case Report and Review of the Literature. Case Rep Nephrol 2022; 2022:8500299. [PMID: 35813243 PMCID: PMC9259234 DOI: 10.1155/2022/8500299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/31/2022] [Indexed: 01/18/2023] Open
Abstract
Foreign bodies such as implanted cardiac devices are susceptible to infections and may be involved in infective endocarditis. Exposure to pathogens, by frequent use of intravascular accesses for hemodialysis (i.e., catheters or fistulas), combined with high rates of degenerative heart valve diseases in hemodialysis patients, both favor the development of infective endocarditis in this population. The mitral and aortic valves are predominantly implicated in endocardial infections. The involvement of both mitral and tricuspid valves is rare in the general population but can occur in hemodialysis patients with implanted cardiac devices. Infective endocarditis is associated with high morbidity and mortality rates among hemodialysis patients, mostly because of the complications of septic emboli. Prevention, prophylaxis, and early diagnosis of endocarditis can be lifesaving in this fragile population. We report a case of right and left heart methicillin-sensitive Staphylococcus aureus endocarditis with cerebral septic emboli in an elderly hemodialysis patient carrier of an arteriovenous fistula and an ipsilateral nonleadless pacemaker.
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8
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Yang LY, Lee BO, Lee KN, Chen CA. Effects of Electrical Stimulation of Acupoints on Xerostomia for Patients Who Undergo Hemodialysis. Healthcare (Basel) 2022; 10:healthcare10030498. [PMID: 35326976 PMCID: PMC8954393 DOI: 10.3390/healthcare10030498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/25/2022] Open
Abstract
Xerostomia plays a major role in higher interdialytic weight gain (IDWG), which causes cardiovascular complications in patients who undergo hemodialysis. However, few studies have determined a method to manage xerostomia. This study determines the effect of transcutaneous electrical acupoint stimulation (TEAS) on hemodialysis patients with xerostomia and the percentage of IDWG. The study was a single-blind and quasi-experimental study. There are 75 participants: 37 in the TEAS group and 38 in the contrast group. The TEAS group used 250 µs and 50 Hz and the contrast group used 50 µs and 2 Hz three times a week for 3 weeks to stimulate ST 6 and TE17 acupoints. The salivary flow rates, dry mouth, and %IDWG were determined before, during and one week after the program. Compared with the contrast group, the TEAS group showed a significantly improved salivary flow rate (mL/min) (F (2, 123) = 15.28, p < 0.0001), and patients recovered their normal salivary flow rate. However, the results show that both groups showed significant improvement in dry mouth after treatment. The TEAS group demonstrated no effect in terms of %IDWG, as expected. The results show that a TEAS program is an effective means of symptom management for xerostomia patients who undergo hemodialysis. A TEAS program can be used to manage symptoms for xerostomia patients who undergo hemodialysis.
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Affiliation(s)
- Li-Yu Yang
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (L.-Y.Y.); (B.-O.L.)
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (L.-Y.Y.); (B.-O.L.)
| | - Kai-Ni Lee
- Department of Nephrology, Tainan Sinlau Hospital, Tainan 701002, Taiwan;
| | - Chien-An Chen
- Department of Nephrology, Tainan Sinlau Hospital, Tainan 701002, Taiwan;
- Correspondence: ; Tel.: +886-6-2748316 (ext. 2100)
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Aljarie M, Alahmari M, Arabi M. Central Venoplasty in Patients with Cardiac Implantable Electronic Devices. THE ARAB JOURNAL OF INTERVENTIONAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1730121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Abstract
Objective The aim of this study was to assess the safety and effectiveness of the central venous angioplasty in patients with central venous occlusion and cardiac implantable electronic device (CIED) without lead extraction.
Materials and Methods A retrospective study was used to evaluate the effectiveness of 37 central venous angioplasty procedure for 15 patients with CIED without lead extraction.
Results Technical success was achieved in 97% (n = 36/37) and clinical success was achieved in 89% (33/37) of the procedures. One procedure failed recanalization of chronic total occlusion of the left subclavian vein, and the patient required fistula embolization due to severe arm swelling. Another procedure failed initially to recanalize long-segment occlusion involving the right subclavian vein/brachiocephalic vein and superior vena cava in a patient with a history of Hickman line and left-sided CIED. This was successfully recanalized and angioplastied on a subsequent session. No lead fracture or dislodgment was documented in any procedure. No procedure-related complication was documented within 2 weeks after the angioplasty. Six-month primary patency was achieved in 62% (23/37) of the procedures. Ten patients (66%) required an average of 1.4 reinterventions (range: 1–4 interventions) during the follow-up time with mean time to reintervention of 318 days (5–1,380 days). Two patients required early reinterventions within 10 days due to catheter dysfunction.
Conclusion Findings of this study support the existing evidence on the safety and effectiveness of balloon angioplasty without lead extraction.
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Affiliation(s)
- Mohammed Aljarie
- Division of Vascular and Interventional Radiology, Department of Medical Imaging, Ministry of National Guard - Health Affairs; King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Alahmari
- Division of Vascular and Interventional Radiology, Department of Medical Imaging, Ministry of National Guard - Health Affairs; King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammad Arabi
- Division of Vascular and Interventional Radiology, Department of Medical Imaging, Ministry of National Guard - Health Affairs; King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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10
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Lead-related superior vena cava syndrome: Management and outcomes. Heart Rhythm 2020; 18:207-214. [PMID: 32920177 DOI: 10.1016/j.hrthm.2020.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/18/2020] [Accepted: 09/06/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Superior vena cava (SVC) syndrome includes the clinical sequalae of facial and bilateral upper extremity edema, dizziness, and occasional syncope. Historically, most cases have been associated with malignancy and treatment is palliative. However, cardiac device leads have been identified as important nonmalignant causes of this syndrome. There are little data on the effectiveness of venoplasty and lead extraction in the management of these patients. OBJECTIVE The objective of this study was to report the findings associated with the use of balloon angioplasty and lead extraction in the management of 17 patients with lead induced SVC syndrome. METHODS Data collected from January 2003 to July 2019 identified 17 cases of SVC syndrome at our tertiary center. Their outcomes were compared to a control group of patients without SVC syndrome. A P value of <.05 was considered statistically significant. RESULTS Of the 17 patients, 13 (76%) underwent transvenous lead extraction and venoplasty. Three patients (18%) were treated with venoplasty alone, and 1 patient (6%) underwent surgical SVC reconstruction. In 10 patients (59%), transvenous reimplantation was necessary. Symptom resolution was achieved in all 17 patients and confirmed at both 6 and 12 months' follow-up. There was no significant difference in the rate of complications associated with transvenous lead extraction for SVC syndrome vs control. CONCLUSION In patients with SVC syndrome, venoplasty and lead extraction are safe and effective for resolution of symptoms and maintaining SVC patency.
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Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, Allon M, Asif A, Astor BC, Glickman MH, Graham J, Moist LM, Rajan DK, Roberts C, Vachharajani TJ, Valentini RP. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 2020; 75:S1-S164. [PMID: 32778223 DOI: 10.1053/j.ajkd.2019.12.001] [Citation(s) in RCA: 913] [Impact Index Per Article: 228.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/09/2019] [Indexed: 02/07/2023]
Abstract
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for hemodialysis vascular access since 1996. Since the last update in 2006, there has been a great accumulation of new evidence and sophistication in the guidelines process. The 2019 update to the KDOQI Clinical Practice Guideline for Vascular Access is a comprehensive document intended to assist multidisciplinary practitioners care for chronic kidney disease patients and their vascular access. New topics include the end-stage kidney disease "Life-Plan" and related concepts, guidance on vascular access choice, new targets for arteriovenous access (fistulas and grafts) and central venous catheters, management of specific complications, and renewed approaches to some older topics. Appraisal of the quality of the evidence was independently conducted by using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and interpretation and application followed the GRADE Evidence to Decision frameworks. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.
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12
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Burbelko M. [Thoracic Central Venous Occlusive Disease and Haemodialysis Access]. Zentralbl Chir 2020; 145:473-480. [PMID: 32120444 DOI: 10.1055/a-1014-3538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Benign central venous thoracic occlusion is a frequent issue in haemodialysis patients. Symptomatic stenosis affects quality of life and can cause dysfunction of arteriovenous access or make it impossible to implant a haemodialysis catheter. Common risk factors for the development of the occlusions are central venous catheters and cardiac rhythm devices. The gold standard for diagnosis is venous angiography. Treatment of asymptomatic lesions can lead to clinical deterioration and should be avoided. The primary method of treatment for symptomatic patients is endovascular therapy. Repeat balloon angioplasty is a standard therapy. In case of elastic recoiling or early recurrence, placement of bare metal stent or stent graft could be considered. Surgical options should be preserved only for refractory cases. Further randomised trials are needed to prove the efficacy of new devices, such as dedicated venous stents and drug coated balloons.
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Affiliation(s)
- Michael Burbelko
- Institut für Radiologie und Interventionelle Therapie, Vivantes Klinikum im Friedrichshain, Berlin, Deutschland
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13
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Jha AK, Lata S. Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision-making. Clin Transplant 2020; 34:e13795. [PMID: 31991012 DOI: 10.1111/ctr.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/21/2019] [Accepted: 01/24/2020] [Indexed: 11/30/2022]
Abstract
Increasing comorbidities and an aging population have led to a tremendous increase in the burden of both kidney and cardiac dysfunction. Concomitant cardiomyopathy exposes the patients with kidney disease to further physiological, hemodynamic, and pathologic alterations. Kidney transplantation imposes lesser anesthetic and surgical complexities compared to another solid organ transplant. The surgical decision-making remains an unsettled issue in these conditions. The surgical choices, techniques, and sequences in kidney transplant and cardiac surgery depend on the pathophysiological perturbations and perioperative outcomes. The absence of randomized controlled trials eludes us from suggesting definite management protocol in patients with end-stage kidney disease with cardiomyopathy. Nevertheless, in this review, we extracted data from published literature to understand the pathophysiologic interactions between end-stage renal diseases with cardiomyopathy and also proposed the management algorithm in this challenging scenario. The proposed management algorithm would ensure consensus across all stakeholders involved in decision-making. Our simplistic evidence-based approach would augur future randomized trials and would further ensure refinement in our management approach after the emergence of more definitive evidence.
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Affiliation(s)
- Ajay Kumar Jha
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Suman Lata
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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14
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Steele L, Flowers D, Coles S, Gibbs P. Pulsatile tinnitus as a presenting symptom of central venous stenosis secondary to an ipsilateral upper arm arteriovenous PTFE graft. BMJ Case Rep 2019; 12:12/7/e229398. [PMID: 31350227 DOI: 10.1136/bcr-2019-229398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 51-year-old man presented with a swollen left arm and unilateral pulsatile tinnitus 2 weeks after a left upper arm polytetrafluoroethylene graft was created for haemodialysis access. A fistulogram of the left upper arm showed a central venous stenosis and significant retrograde flow up the left internal jugular vein. Percutaneous transluminal angioplasty was attempted unsuccessfully and fistula ligation was subsequently performed. This led to immediate resolution of the tinnitus. The venous stenosis was likely secondary to a cardiac resynchronisation therapy defibrillator, which had been removed 1 year previously. Central venous stenosis is a common but often asymptomatic complication of a cardiac device, with the exception of patients with upper extremity arteriovenous fistulas, who frequently develop symptomatic venous hypertension. This generally presents with ipsilateral arm swelling and/or high venous pressures during dialysis. To our knowledge, this is the first report of pulsatile tinnitus arising in this context.
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Affiliation(s)
- Lloyd Steele
- Imperial College Healthcare NHS Trust, London, UK.,Wessex Kidney Centre, Queen Alexandra Hospital, Portsmouth, UK
| | - David Flowers
- Department of Interventional Radiology, Queen Alexandra Hospital, Portsmouth, UK
| | - Simon Coles
- Department of Interventional Radiology, Queen Alexandra Hospital, Portsmouth, UK
| | - Paul Gibbs
- Wessex Kidney Centre, Queen Alexandra Hospital, Portsmouth, UK
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15
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Sherk WM, Khaja MS, Good ED, Cunnane RT, Dasika NL, Williams DM. Hybrid venous recanalization and cardiac implantable electronic device lead revision procedures: A single-center retrospective analysis of 38 patients. Clin Imaging 2019; 58:145-151. [PMID: 31336361 DOI: 10.1016/j.clinimag.2019.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe the safety and efficacy of hybrid recanalization procedures in a series of patients with obstructed central veins requiring cardiac implantable electronic device (CIED) revision. METHODS Between 2008 and 2016, 38 consecutive patients (24 M; age 60.5 ± 16.2 years; range 25-87 years) with central venous obstruction underwent 42 recanalization interventions performed in conjunction with CIED revision or extraction. Fifty percent of patients (19/38) presented with veno-occlusive symptoms, and 13% (5/38) of patients had CIED leads with an ipsilateral upper extremity dialysis conduit. RESULTS Ninety-one percent (38/42) of all procedures resulted in successful recanalization and CIED revision. Twenty-four percent (9/38) of all patients required secondary procedures due to recurrent stenosis, and 78% (7/9) of those requiring secondary procedures had indwelling dialysis conduits and/or clinical symptoms related to venous occlusion before the initial procedure. There were complications in 2 patients related to recanalization, and in 3 related to CIED revision. CONCLUSIONS Recanalization of central venous stenosis/occlusion in patients with CIED can be technically challenging but is successful in most patients. Symptomatic patients and those with dialysis conduits often require more aggressive revascularization interventions and may be at increased risk of complication or need for secondary interventions.
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Affiliation(s)
- William M Sherk
- Department of Radiology, Division of Vascular & Interventional Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America.
| | - Minhaj S Khaja
- Department of Radiology, Division of Vascular & Interventional Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America.
| | - Eric D Good
- Division of Cardiology, Section of Electrophysiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI 48109, United States of America
| | - Ryan T Cunnane
- Division of Cardiology, Section of Electrophysiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI 48109, United States of America.
| | - Narasimham L Dasika
- Department of Radiology, Division of Vascular & Interventional Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America.
| | - David M Williams
- Department of Radiology, Division of Vascular & Interventional Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America.
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16
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Mehdi B, Kaveh H, Ali VF. Implantable Cardioverter-Defibrillators in Patients with ESRD: Complications, Management, and Literature Review. Curr Cardiol Rev 2019; 15:161-166. [PMID: 30657044 PMCID: PMC6719391 DOI: 10.2174/1573403x15666190118123754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/26/2018] [Accepted: 01/10/2019] [Indexed: 01/25/2023] Open
Abstract
Background: Cardiovascular diseases are the leading cause of death among dialysis pa-tients, accounting for about 40% of all their mortalities. Sudden cardiac death (SCD) is culpable for 37.5% of all deaths among patients with end-stage renal disease (ESRD). Implantable cardioverter-defibrillators (ICDs) should be considered in dialysis patients for the primary or secondary preven-tion of SCD. Recent studies on the implementation of ICD/cardiac resynchronization therapy do not exclude patients with ESRD; however, individualized decisions should be made in this group of pa-tients. A thorough evaluation of the benefits of ICD implementation in patients with ESRD requires several large-scale mortality studies to compare and follow up patients with ESRD with and without ICDs. In the present study, we sought to determine and clarify the complications associated with ICD implementation and management thereof in patients suffering from ESRD. Methods: To assess the complications allied to the implementation of ICDs and their management in patients with ESRD, we reviewed available related articles in the literature. Results and Conclusions: ICD implementation in dialysis patients has several complications, which has limited its usage. Based on our literature review, the complications of ICD implementation can be categorized as follows: (1) Related to implantation procedures, hematoma, and pneumothorax; (2) Re-lated to the device/lead such as lead fracture and lead dislodgment; (3) Infection; and (4) Central vein thrombosis. Hence, the management of the complications of ICDs in this specific group of patients is of vital importance.
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Affiliation(s)
- Bayati Mehdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosseini Kaveh
- Cardiology Resident, MS in Public Health, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vasheghani-Farahani Ali
- Cardiac Primary Prevention, Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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17
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Impact of chronic kidney disease on recurrent ventricular tachyarrhythmias in ICD recipients. Heart Vessels 2019; 34:1811-1822. [DOI: 10.1007/s00380-019-01415-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 04/19/2019] [Indexed: 01/24/2023]
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18
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Ng JB, Chua K, Teo WS. Simultaneous leadless pacemaker and subcutaneous implantable cardioverter-defibrillator implantation-When vascular options have run out. J Arrhythm 2019; 35:136-138. [PMID: 30805055 PMCID: PMC6373655 DOI: 10.1002/joa3.12140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/19/2018] [Accepted: 10/13/2018] [Indexed: 12/30/2022] Open
Abstract
An end-stage renal failure patient who was planned for a left brachioaxillary arteriovenous graft required an implantable cardioverter-defibrillator for secondary prevention of ventricular tachycardia and a pacemaker for complete heart block but was found to have a right subclavian venous occlusion. Due to the lack of vascular access, we performed a successful subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemaker implantation. There was no interaction between the devices at the time of implantation, during defibrillation testing and following an appropriate defibrillation therapy.
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19
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Jeong S, Nam GB, Chang JW, Kim MJ, Han Y, Kwon TW, Cho YP. Impact of transvenous cardiac implantable electronic devices in chronic hemodialysis patients: a single-center, observational comparative study. BMC Nephrol 2018; 19:281. [PMID: 30342493 PMCID: PMC6195973 DOI: 10.1186/s12882-018-1095-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 10/10/2018] [Indexed: 11/27/2022] Open
Abstract
Background We investigated the impact of a transvenous cardiac implantable electronic device (CIED) placement on outcomes and arteriovenous vascular access (VA) patency among chronic hemodialysis patients. Methods This is a single-center, observational comparative study between chronic hemodialysis patients with ipsilateral and contralateral CIED and VA. Forty-two consecutive patients who underwent both CIED placement and upper-extremity VA for hemodialysis, regardless of the sequence and time interval between these 2 procedures, were identified between January 2001 and December 2017. Patients with ipsilateral (n = 22, 52%, the ipsilateral group) and contralateral (n = 20, 48%, the contralateral group) CIED and VA were compared retrospectively; the primary outcome was any-cause mortality and cardiac mortality or the composite of any systemic complications, defined as central venous stenosis or occlusion, any device infections or tricuspid regurgitation; the secondary outcome was CIED or VA malfunction. Results During the median follow-up period of 101 months, primary outcome incidence was significantly higher in the ipsilateral group than the contralateral group (73% vs 40%, P = 0.03), although the incidences of any-cause mortality (P = 0.28) and cardiac mortality (P > 0.99) were similar between the groups. Secondary outcome incidence did not differ significantly between the 2 groups (55% vs 30%, P = 0.36). Kaplan–Meier survival analysis revealed similar primary and secondary VA patency rates in both groups. On subgroup analysis, patients with upper arm VA had similar primary and secondary patency to those with forearm VA. Conclusions Despite some notable limitations of the study, the retrospective study design and small sample size, we found that the any-cause mortality incidence and VA patency did not differ between the 2 groups, but primary outcome incidence was significantly higher among patients with ipsilateral CIED and VA.
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Affiliation(s)
- Seonjeong Jeong
- Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, Republic of Korea
| | - Gi Byoung Nam
- Division of Cardiology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jai Won Chang
- Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Min-Ju Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Youngjin Han
- Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, Republic of Korea
| | - Tae-Won Kwon
- Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, Republic of Korea
| | - Yong-Pil Cho
- Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Seoul, 05505, Republic of Korea.
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20
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Sgroi MD, McFarland G, Itoga NK, Sorial E, Garcia-Toca M. Arteriovenous Fistula and Graft Construction in Patients with Implantable Cardiac Devices: Does Side Matter? Ann Vasc Surg 2018; 54:66-71. [PMID: 30339901 DOI: 10.1016/j.avsg.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Limited reports have documented the effect cardiac implantable electronic devices (CIEDs) have on arteriovenous (AV) access patency. Current recommendations suggest placing the access on the contralateral side of the CIEDs, as there is concern for increased central venous stenosis and access failure. The goal of this study is to review our single-center AV access patency rates for dialysis patients with an ipsilateral or contralateral side CIED. METHODS A retrospective review was performed from 2008 to 2016 at a single institution identifying all patients who have received a CIED and the diagnosis of end-stage renal disease (ESRD). Medical records were queried to identify each patient's dialysis access and whether it was ipsilateral or contralateral to the CIED. Primary outcomes of study were primary and secondary patency rates. RESULTS A total of 44 patients were identified to have ESRD and CIED. Of these patients, 28 patients with fistulas or grafts (13 ipsilateral and 15 contralateral) had follow-up with regards to their AV access. There were 3 primary failures in both groups. For patients who had the CIED placed after already starting the dialysis, patency was based on when the cardiac device was implanted. Primary patency for ipsilateral and contralateral access was 20.2 and 22.2 months, respectively. With secondary interventions, ipsilateral and contralateral mean patency was 39 and 48.8 months, respectively. Six-month and 1-year primary patency for arteriovenous fistula or arteriovenous graft on patients with ipsilateral access was 69.2% and 53.8%, respectively. Ipsilateral 1-year cumulative patency was 39 months. CONCLUSIONS CIED may lead to stenosis or occlusion to one's AV access; however, primary assisted and secondary patency rates are still acceptable at 6 months and 1 year compared to Kidney Disease Outcomes Quality Initiative guidelines. Despite a CIED, a surgeon's algorithm should not lead to the abandonment of an ipsilateral access if the central venous system is patent.
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Affiliation(s)
- Michael D Sgroi
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA.
| | - Graeme McFarland
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA
| | - Nathan K Itoga
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA
| | - Ehab Sorial
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA
| | - Manuel Garcia-Toca
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA
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21
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Tedla FM, Clerger G, Distant D, Salifu M. Prevalence of Central Vein Stenosis in Patients Referred for Vein Mapping. Clin J Am Soc Nephrol 2018; 13:1063-1068. [PMID: 29739749 PMCID: PMC6032590 DOI: 10.2215/cjn.14001217] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 04/20/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Central vein stenosis is considered to be common in patients on hemodialysis but its exact prevalence is not known. In this study, we report the prevalence of central vein stenosis in patients with CKD referred for vein mapping. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a retrospective study of adult patients who had bilateral upper extremity venographic vein mapping from September 1, 2011 to December 31, 2015. Patients with and without stenosis were compared for differences in clinical or demographic characteristics. Multiple logistic regression was used to identify independent associations between patient characteristics and central vein stenosis. RESULTS There were 525 patients who underwent venographic vein mapping during the study period, 27% of whom were referred before initiation of hemodialysis. The mean age (±SD) and body mass index were 59 (±15) years and 28 (±7), respectively. Women accounted for 45% of patients; 82% were black. The prevalence of central vein stenosis was 10% (95% confidence interval [95% CI], 8% to 13%) for the whole group, and 13% (95% CI, 10% to 17%) among patients with tunneled central venous dialysis catheters. Current use of tunneled hemodialysis catheters (odds ratio [OR], 14.5; 95% CI, 3.25 to 65.1), presence of cardiac rhythm devices (OR, 5.07; 95% CI, 1.82 to 14.11), previous history of fistula or graft (OR, 3.28; 95% CI, 1.58 to 6.7), and history of previous kidney transplant (OR, 18; 95% CI, 4.7 to 68.8) were independently associated with central vein stenosis. CONCLUSIONS In this population, the prevalence of central vein stenosis was 10% and was clustered among those with tunneled hemodialysis catheters, cardiac rhythm device, and previous history of dialysis access or transplant.
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Affiliation(s)
| | | | - Dale Distant
- Department of Surgery, State University of New York Downstate Medical Center, Brooklyn, New York
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22
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Anwar S, Vachharajani TJ. Stent use for hemodialysis access: What a general nephrologist needs to know. Hemodial Int 2017; 22:143-149. [DOI: 10.1111/hdi.12608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Siddiq Anwar
- Nephrology Section; King Faisal Specialist Hospital and Research Center; Riyadh Saudi Arabia
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23
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24
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Vachharajani TJ, Salman L, Costanzo EJ, Mehandru SK, Patel M, Calderon DM, Mathew RO, Sidhu MS, Asif A. Subcutaneous defibrillators for dialysis patients. Hemodial Int 2017. [DOI: 10.1111/hdi.12577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Loay Salman
- Department of Medicine; Albany Medical College; Albany New York
| | - Eric J. Costanzo
- Department of Medicine; Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine; Neptune New Jersey USA
| | - Sushil K. Mehandru
- Department of Medicine; Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine; Neptune New Jersey USA
| | - Mayurkumar Patel
- Department of Medicine; Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine; Neptune New Jersey USA
| | - Dawn M. Calderon
- Department of Medicine; Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine; Neptune New Jersey USA
| | | | | | - Arif Asif
- Department of Medicine; Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine; Neptune New Jersey USA
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25
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Scher LA, Shariff S. Strategies for Hemodialysis Access: A Vascular Surgeon’s Perspective. Tech Vasc Interv Radiol 2017; 20:14-19. [DOI: 10.1053/j.tvir.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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26
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Saad TF, Weiner HL. Venous Hemodialysis Catheters and Cardiac Implantable Electronic Devices: Avoiding a High-Risk Combination. Semin Dial 2017; 30:187-192. [PMID: 28229483 DOI: 10.1111/sdi.12581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
End-stage renal disease is frequently accompanied by cardiac comorbidity that warrants treatment with a cardiovascular implantable electronic device (permanent pacemaker or implantable cardioverter-defibrillator). In the United States, chronic hemodialysis (HD) population, cardiac implantable devices are present in up to 10.5% of patients; a venous HD catheter is utilized for blood access in 18% of prevalent patients. The concomitant presence of a venous HD catheter and cardiovascular implantable device creates a high-risk circumstance, with potential for causing symptomatic central venous stenosis, and for developing complicated endovascular infection. This dangerous combination may be avoided for many patients by utilizing nondialysis methods for management of advanced chronic kidney disease, initiating dialysis without venous catheter access, or managing cardiac rhythm disorders without use of transvenous cardiac implantable electronic devices. In those situations where the combination of a venous HD catheter and cardiac implantable device is unavoidable, there are strategies to minimize duration of venous catheter access, and to reduce risks for infectious complications. It is essential for nephrologists and cardiologists to understand the indications, alternatives, and risks involved with venous HD access and cardiac implantable devices. Coordinated management of renal disease and cardiac rhythm disorders has potential to minimize risks, improve outcomes, and substantially reduce the cost of care.
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Affiliation(s)
- Theodore F Saad
- Section of Renal and Hypertensive Diseases, Christiana Care Health System, Newark, Delaware
| | - Henry L Weiner
- Section of Cardiology, Christiana Care Health System, Newark, Delaware
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27
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Norton de Matos A, Teixeira G, Almeida P, Ventura A, Pereira S, Rego D, Sousa CN. Ipsilateral Basilic Vein Transposition in a Patient With a Pacemaker. Ther Apher Dial 2016; 20:535-537. [PMID: 27523400 DOI: 10.1111/1744-9987.12417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 01/22/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - Gabriela Teixeira
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Angiology and Vascular Surgery Department, Centro Hospitalar do Porto, Portugal
| | - Paulo Almeida
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Angiology and Vascular Surgery Department, Centro Hospitalar do Porto, Portugal
| | - Ana Ventura
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Nephrology Department, Centro Hospitalar Vila Nova Gaia, Portugal
| | - Susana Pereira
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Nephrology Department, Centro Hospitalar Vila Nova Gaia, Portugal
| | - Duarte Rego
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Angiology and Vascular Surgery Department, Centro Hospitalar do Porto, Portugal
| | - Clemente Neves Sousa
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Portugal.,Nursing College Porto (Escola Superior Enfermagem Porto), Portugal
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28
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Bhatti NK, Karimi Galougahi K, Paz Y, Nazif T, Moses JW, Leon MB, Stone GW, Kirtane AJ, Karmpaliotis D, Bokhari S, Hardy MA, Dube G, Mohan S, Ratner LE, Cohen DJ, Ali ZA. Diagnosis and Management of Cardiovascular Disease in Advanced and End-Stage Renal Disease. J Am Heart Assoc 2016; 5:JAHA.116.003648. [PMID: 27491836 PMCID: PMC5015288 DOI: 10.1161/jaha.116.003648] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Navdeep K Bhatti
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Keyvan Karimi Galougahi
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Yehuda Paz
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Tamim Nazif
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Jeffrey W Moses
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Martin B Leon
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Gregg W Stone
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Ajay J Kirtane
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Dimitri Karmpaliotis
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
| | - Sabahat Bokhari
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Mark A Hardy
- Department of Surgery, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Geoffrey Dube
- Division of Nephrology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Sumit Mohan
- Division of Nephrology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Lloyd E Ratner
- Department of Surgery, New York Presbyterian Hospital and Columbia University, New York, NY
| | - David J Cohen
- Division of Nephrology, New York Presbyterian Hospital and Columbia University, New York, NY
| | - Ziad A Ali
- Division of Cardiology, New York Presbyterian Hospital and Columbia University, New York, NY Cardiovascular Research Foundation, New York, NY
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Boriani G, Savelieva I, Dan GA, Deharo JC, Ferro C, Israel CW, Lane DA, La Manna G, Morton J, Mitjans AM, Vos MA, Turakhia MP, Lip GY. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical significance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. Europace 2015; 17:1169-96. [PMID: 26108808 PMCID: PMC6281310 DOI: 10.1093/europace/euv202] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Giuseppe Boriani
- Corresponding author. Giuseppe Boriani, Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S.Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy. Tel: +39 051 349858; fax: +39 051 344859. E-mail address:
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30
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Dhamija RK, Tan H, Philbin E, Mathew RO, Sidhu MS, Wang J, Saour B, Haqqie SS, Beathard G, Yevzlin AS, Salman L, Boden WE, Siskin G, Asif A. Subcutaneous Implantable Cardioverter Defibrillator for Dialysis Patients: A Strategy to Reduce Central Vein Stenoses and Infections. Am J Kidney Dis 2015; 66:154-8. [DOI: 10.1053/j.ajkd.2015.01.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 01/07/2015] [Indexed: 11/11/2022]
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31
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Fan WF, Zhang Q, Luo LH, Niu JY, Gu Y. Study on the clinical significance and related factors of thirst and xerostomia in maintenance hemodialysis patients. Kidney Blood Press Res 2013; 37:464-74. [PMID: 24247643 DOI: 10.1159/000355717] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2013] [Indexed: 11/19/2022] Open
Abstract
AIMS To analyse the clinical significance and related factors of thirst and xerostomia and to find methods to alleviate thirst and xerostomia in maintenance hemodialysis (MHD) patients. METHODS Forty-two MHD patients were included for observational study and eleven patients were enrolled for crossover trial. Thirst was assessed by 100-mm visual analog scales (VAS) and dialysis thirst inventory (DTI). Meanwhile, xerostomia was assessed by VAS and xerostomia inventory (XI). Depression, kidney disease quality of life (KDQOL), salivary flow rates and inter dialytic weight gain (IDWG) were measured. Data were analyzed by ANOVA and correlation coefficient was used to assess the correlations between continuous variables. The results of crossover trial were investigated by two-sample T-tests. RESULTS Strong positive correlations among DTI, VAS thirst score, XI and VAS xerostomia score were found (P=0.000). Daily IDWG was positively correlated with VAS thirst score (r=0.315, P=0.042) and DTI(r=0.391, P=0.010). UWS (unstimulated whole saliva) was negatively correlated with VAS xerostomia score (r=-0.308, P=0.048). Residual urine output was negatively correlated with DTI (r=-0.402, P=0.008), VAS xerostomia score (r=-0.461, P=0.002) and XI (r=-0.403, P=0.008). In the crossover trial, DTI, XI, IDWG2d, IDWG3d, VAS thirst and xerostomia score were significantly reduced by the use of chewing gum (P=0.000, 0.001, 0.009, 0.017, 0.038, 0.001). The VAS thirst score, DTI and IDWG3d were significantly reduced by receiveing straw (P=0.016, 0.003, 0.049). CONCLUSION Thirst and xerostomia might affect the quality of life in MHD patients. Both chewing gum and straw could decrease thirst and IDWG.
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Affiliation(s)
- Wei-Feng Fan
- Division of Nephrology, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
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