1
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Ko CY, Yu LY, Chen PW, Ko CC, Lin TX, Lee CH, Liu PY, Chang HY. Manual compression technique improves the success rate in the treatment of thrombosed aneurysmal arteriovenous fistula: A single-center experience. Semin Dial 2023; 36:374-381. [PMID: 36263693 DOI: 10.1111/sdi.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Endovascular intervention for thrombosed aneurysmal arteriovenous fistula (AVF) is still a challenge. Manual compression technique (MCT)-assisted angioplasty may be helpful, but there is no evidence or data to support it. METHODS From January 2018 to May 2021, patients with thrombosed aneurysmal AVFs were retrospectively enrolled. The patients were separated into the MCT group or the traditional group according to the procedure received. Technical failure, clinical failure, 90-day patency, and safety were analyzed. RESULTS A total of 159 cases (64 ± 12 years old, 60% male) were enrolled, of which 87 cases received MCT and 72 underwent traditional angioplasty. No technical failure was observed in the MCT group, while five technical failures were observed in the traditional group (0% vs. 7%, p = 0.02). There were no differences in the clinical failure rate (3% vs. 7%, p = 0.30), 90-day patency rate, or procedure time between the MCT group and the traditional group. There was no symptomatic pulmonary embolism or other complication in the two groups. CONCLUSION MCT is a low-cost, less invasive, and safe procedure for thrombosed aneurysmal AVF, and it achieves a higher technical success rate than traditional angioplasty.
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Affiliation(s)
- Cheng-Yu Ko
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Ying Yu
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Chang Ko
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tian-Xi Lin
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liu Branch, College of Medicine, National Cheng Kung University, Yun-Lin, Taiwan
| | - Cheng-Han Lee
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ping-Yen Liu
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsien-Yuan Chang
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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2
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Deogaonkar G, Thulasidasan N, Phulambrikar R, Diamantopoulos A, Sran K, Ahmed I, Loukopoulos I, Karunanithy N. Endovascular salvage of thrombosed haemodialysis vascular access. VASA 2023; 52:63-70. [PMID: 36464999 DOI: 10.1024/0301-1526/a001043] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Haemodialysis access thrombosis is associated with significant morbidity and access abandonment rates, for which endovascular salvage is a well described treatment option. This study aimed to evaluate the outcomes of endovascular salvage procedures of thrombosed vascular access circuits and identify factors influencing outcomes. Patients and methods: Retrospective review of 328 consecutive procedures performed over 10 years at our institution between January 2010 and December 2019. Patient demographics, access circuit characteristics, procedure details and outcome data were collected. Kaplan-Meier survival curves were used to estimate patency rates and Cox multivariate regression analysis to identify factors affecting outcomes. Results: Technical and clinical success rates were 87.8% and 75.9% respectively. The primary, primary assisted and secondary patency rates at 6 months were 42.2%, 46.7% and 59.1%; and at 12 months were 23.4%, 28.3% and 41.8% respectively. Median access circuit survival was 9.2 months. Major complication rate was 5.2% including 3 procedure-related deaths. Native AVF, lower time from thrombosis to intervention and pharmacomechanical thrombectomy using AngioJetTM predicted positive outcomes. Previous thrombectomy within 3 months and residual thrombus at completion were associated with poorer outcomes. Age and hypertension predicted higher complication rates. Conclusions: This is one of the largest single center series of endovascular salvage of thrombosed haemodialysis access and demonstrates that endovascular treatment is effective and provides durable access circuit survival. Careful patient screening is essential to optimize outcomes.
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Affiliation(s)
- Ganesh Deogaonkar
- Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Narayanan Thulasidasan
- Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Rutuja Phulambrikar
- Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | | - Kiran Sran
- Department of Nephrology & Transplantation, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Irfan Ahmed
- Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Ioannis Loukopoulos
- Department of Nephrology & Transplantation, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Narayan Karunanithy
- Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, UK.,School of Biomedical Engineering & Imaging Sciences, King's College London, UK
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3
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Spanuchart I, Amin B, Sequeira A, Virk C, Abreo K, Sachdeva B. Catheter-directed thrombolytic infusion for thrombosed arteriovenous fistulas with a large clot burden: A case series. J Vasc Access 2021; 23:950-955. [PMID: 33947278 DOI: 10.1177/11297298211011916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Arteriovenous fistula (AVF) thrombosis occurs less often when compared to arteriovenous grafts. Since the number of AVFs has increased in the United States, AVF thrombosis is seen more frequently today. AVF thrombectomy can be tedious, requires physician ingenuity, and many times results in failure. Substantial clot burden in megafistulas and aneurysms is considered a relative contraindication to endovascular thrombectomy. Usually, it results in surgical referral for open thrombectomy or, at times, abandonment of the fistula altogether. Herein, we describe the technique, results, and cautions of combining a continuous infusion of recombinant tissue plasminogen (rTPA) followed by angioplasty of the culprit stenotic lesion that was successful in opening five of six AVFs with a substantial clot burden.
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Affiliation(s)
- Ittikorn Spanuchart
- Division of Nephrology and Hypertension, Louisiana State University Health Science Center in Shreveport, LA, USA.,Division of Nephrology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Bakhtiar Amin
- Division of Nephrology and Hypertension, Louisiana State University Health Science Center in Shreveport, LA, USA
| | - Adrian Sequeira
- Division of Nephrology and Hypertension, Louisiana State University Health Science Center in Shreveport, LA, USA
| | - Chiranjiv Virk
- Division of Vascular Surgery and Endovascular Surgery, Louisiana State University Health Science Center in Shreveport, LA, USA
| | - Kenneth Abreo
- Division of Nephrology and Hypertension, Louisiana State University Health Science Center in Shreveport, LA, USA
| | - Bharat Sachdeva
- Division of Nephrology and Hypertension, Louisiana State University Health Science Center in Shreveport, LA, USA
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4
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Gubensek J, Avgustin-Rotar N, Premru V. Arteriovenous graft rethrombosis advancing to deep vein thrombosis and pulmonary embolism in the presence of superior vena cava stenosis: A case report. Ther Apher Dial 2021; 25:364-366. [PMID: 33448649 DOI: 10.1111/1744-9987.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Jakob Gubensek
- Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Nusa Avgustin-Rotar
- Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Vladimir Premru
- Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia
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Abe T, Aoyama T, Sano K, Miyasaka R, Yamazaki T, Honma Y, Tominaga H, Ida M, Arao A, Sakakibara M, Hashimoto K, Takahashi H, Sakai T, Naito S, Koitabashi T, Sano T, Takeuchi Y. Initiation of peritoneal dialysis in a patient with chronic renal failure associated with tetralogy of Fallot: a case report. BMC Nephrol 2020; 21:277. [PMID: 32669094 PMCID: PMC7364813 DOI: 10.1186/s12882-020-01939-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 07/08/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Tetralogy of Fallot is the most common cyanotic congenital heart disease. Patients with the condition have a high risk of developing chronic kidney disease. Treatment of kidney disease in patients with complex hemodynamics presents unique challenges. However, there are very few reports on the treatment of end-stage renal failure in patients with tetralogy of Fallot. CASE PRESENTATION We present a rare case of peritoneal dialysis in a 47-year-old man with tetralogy of Fallot who had not undergone intracardiac repair. Peritoneal dialysis successfully removed fluids and solutes without adversely affecting the patient's hemodynamics. Our patient was managed with peritoneal dialysis for 5 years before he succumbed to sepsis secondary to digestive tract perforation. CONCLUSIONS In this paper, we discuss the importance of monitoring acid-base balance, changes in cyanosis, and hyperviscosity syndrome during peritoneal dialysis in patients with tetralogy of Fallot. Lower leg edema and B-type natriuretic peptide level were useful monitoring parameters in this case. This case illustrates that with attention to the patient's unique requirements, peritoneal dialysis can provide successful renal replacement therapy without compromising hemodynamics in patients with tetralogy of Fallot.
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Affiliation(s)
- Tetsuya Abe
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan.
| | - Togo Aoyama
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Keiko Sano
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Ryoma Miyasaka
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Takuya Yamazaki
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Yukari Honma
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Hiroshi Tominaga
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Maoko Ida
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Aya Arao
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Mayuko Sakakibara
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Keiko Hashimoto
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Haruka Takahashi
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Takeshi Sakai
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Shokichi Naito
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Toshimi Koitabashi
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Takashi Sano
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
| | - Yasuo Takeuchi
- Department of Nephrology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0375, Japan
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6
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Ng KK, Rozental T. Lethal Pulmonary Embolism Following Left Upper Extremity Angiogram/Angioplasty with Thrombectomy at Malfunctioning Arteriovenous Fistula. Cureus 2020; 12:e7197. [PMID: 32269877 PMCID: PMC7137674 DOI: 10.7759/cureus.7197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 41-one-year-old female on chronic hemodialysis with a medical history of systemic lupus erythematosus and end-stage renal disease presented with clotted hemodialysis access. She was sent to the operating room for angiogram/angioplasty with thrombectomy. Although the thrombectomy was successful, toward the end of the case, she went into cardiac arrest secondary to a massive pulmonary embolization that probably originated from her clotted arteriovenous fistula. Spontaneous circulation returned only after a prolonged period of resuscitation using advanced cardiac life support. She was transferred to the medical intensive care unit (ICU) intubated while receiving minimal cardiovascular pharmacological support. Computerized tomography (CT) scan of the head indicated extensive anoxic brain injury and she expired two days later.
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7
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Wan Z, Xiang R, Wang H, Zhong Q, Tu B. Comparative efficacy and safety of local and peripheral venous thrombolytic therapy with urokinase for thrombosed hemodialysis arteriovenous fistulas. Exp Ther Med 2019; 17:4279-4284. [PMID: 30988800 DOI: 10.3892/etm.2019.7415] [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: 09/15/2018] [Accepted: 03/06/2019] [Indexed: 01/13/2023] Open
Abstract
Arteriovenous fistula (AVF) thrombosis is a common complication in patients undergoing hemodialysis, and early intervention is required. Urokinase has been used as a thrombolytic agent for declotting the thrombosed access. However, the optimal route for infusing urokinase remains to be determined. In the present retrospective observational study, 49 patients who underwent local venous infusion and 57 patients with peripheral venous infusion of urokinase were included. A urokinase dosage of 300,000 U was administered until successful thrombolysis, which was a maximum of three times. Age, sex, period of dialysis, time of AVF placement, systolic and diastolic blood pressure and thrombus age were similar between the two groups. The efficacy of urokinase infusion via the two routes in resolving thrombosed AVFs, defined as successful fibrinolysis, and the safety, defined as the number of bleeding events, was compared. The cumulative thrombolysis success rate following three sessions of thrombolytic therapy in the local venous thrombolysis group was higher compared with that in the peripheral venous thrombolysis group (85.7 vs. 68.4%; P=0.04). The local thrombolysis group exhibited less ecchymosis (4.1 vs. 14.0%; P=0.07), epistaxis (2.0 vs. 10.5%; P=0.08) and gingival bleeding (4.1 vs. 19.3%; P=0.02) events compared with the peripheral thrombolysis group. Further analyses demonstrated that systolic [odds ratio (OR)=1.10; 95% confidence interval (CI), 1.03-1.17; P<0.01] and diastolic (OR=1.08; 95% CI, 1.02-1.14; P<0.05) blood pressure were protective factors, whereas thrombus age (OR=0.91; 95% CI, 0.84-0.99; P<0.05) was a risk factor for thrombolysis success among patients who underwent local thrombolytic therapy. Overall, the results suggest that local venous infusion of urokinase is superior to peripheral venous infusion for the treatment of patients with thrombosed fistulas.
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Affiliation(s)
- Ziming Wan
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Rui Xiang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Hui Wang
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Qing Zhong
- Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
| | - Bo Tu
- Department of Ultrasonography, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China
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Abstract
For the over 400,000 patients in the United States dependent on hemodialysis, arteriovenous (AV) access thrombosis may lead to missed dialysis sessions, inpatient admissions and the need for placement of temporary dialysis catheters. It is also the leading cause of permanent access loss. Percutaneous declotting is generally preferred over surgical thrombectomy. Various percutaneous approaches can be employed including the lyse-and-wait technique, thromboaspiration, pulse spray aided pharmacomechanical thrombolysis, and use of mechanical thrombectomy device.
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Affiliation(s)
- Keith Bertram Quencer
- Division of Interventional Radiology, Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Rahmi Oklu
- Division of Interventional Radiology, Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
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9
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Regus S, Lang W, Heinz M, Uder M, Schmid A. Benefits of Long Versus Short Thrombolysis Times for Acutely Thrombosed Hemodialysis Native Fistulas. Vasc Endovascular Surg 2017. [PMID: 28639916 DOI: 10.1177/1538574417715182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution. METHODS We retrospectively analyzed 86 interventional declotting procedures (28 STT and 58 LTT) applied to 86 acutely thrombosed hemodialysis fistulas. The intervention time (IT) following thrombolysis (from the initial fistulography to the end of the angioplasty maneuvers), the time of day of the intervention (ie, during working hours vs off-hours), and the need for temporary catheter placement (TCP) were assessed. Success was defined as complete access recanalization, and major adverse events were defined as ischemia, bleeding, and access rupture. RESULTS The ITs were reduced after LTT (63.3 [9.3] minutes) compared to STT (106.7 [24.7], P = .01), but there was no difference in success rate (85.7% STT, 89.7% LTT, P = .722). While all (100%, 58/58) of the angioplasty maneuvers after LTT were performed during regular working hours, 75% (21/28) of those following STT were managed during off-hours ( P < .001). Despite the longer treatment, the need for TCP was not increased after LTT (10.7%) compared to STT (12.1%, P = .515), and the major complication rate was reduced (3.4% after LTT and 28.6% after STT, P = .004). CONCLUSION Long thrombolysis treatment results in shorter and less complicated percutaneous stenosis treatments during regular working hours. Despite the LTT of up to 25 hours until access for dialysis was achieved, no increase in the risks of TCP or major adverse events were observed following LTT.
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Affiliation(s)
- Susanne Regus
- 1 Department of Vascular Surgery, University Hospital, Erlangen, Germany
| | - Werner Lang
- 1 Department of Vascular Surgery, University Hospital, Erlangen, Germany
| | - Marco Heinz
- 2 Institute of Radiology, University Hospital, Erlangen, Germany
| | - Michael Uder
- 2 Institute of Radiology, University Hospital, Erlangen, Germany
| | - Axel Schmid
- 2 Institute of Radiology, University Hospital, Erlangen, Germany
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10
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Gandolfi M, Fernando BS. Cardiac arrest following arteriovenous fistula manipulation: a cautionary note. BMJ Case Rep 2017; 2017:bcr-2017-220179. [PMID: 28611138 DOI: 10.1136/bcr-2017-220179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Arteriovenous fistulas can lead to a number of different chronic complications. We describe a case where a patient developed a thrombosis within her brachiobasilic arteriovenous fistula, which was manually manipulated in order to restore fistula flow. This resulted in a pulseless electrical activity cardiac arrest within a few minutes. After ten minutes of chest compressions and intubation, there was return of spontaneous circulation. No epinephrine was given nor shocks administered. Patient was extubated within minutes and was alert, orientated and haemodynamically stable. CT pulmonary angiogram showed extensive bilateral pulmonary emboli. Manual manipulation of the arteriovenous fistula lead to significant amounts of thrombus embolising to the pulmonary arteries, and resultant cardiac arrest due to circulatory compromise. Chest compressions likely dislodged these emboli, allowing circulation to recommence. We publish this as a cautionary note of a rare but potentially fatal complication.
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12
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Khraise WN, Allouh MZ, Hiasat MY, Said RS. Successful Management of Intraoperative Acute Bilateral Pulmonary Embolism in a High Grade Astrocytoma Patient. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:632-6. [PMID: 27578311 PMCID: PMC5013976 DOI: 10.12659/ajcr.898912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patient: Female, 39 Final Diagnosis: Acute bilateral pulmonary embolism Symptoms: Headache • amnesia • seizure • urinary incontinence Medication: — Clinical Procedure: — Specialty: Anesthesiology
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Affiliation(s)
- Wail N Khraise
- Department of Anesthesiology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammed Z Allouh
- Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Mohammad Y Hiasat
- Division of Neurosurgery, Department of Neuroscience, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Raed S Said
- Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
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13
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Ohara K, Akimoto T, Miki T, Otani N, Sugase T, Masuda T, Murakami T, Imai T, Takeda SI, Ando Y, Muto S, Nagata D. Therapeutic Challenges to End-Stage Kidney Disease in a Patient with Tetralogy of Fallot. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2015; 8:97-100. [PMID: 26609249 PMCID: PMC4648563 DOI: 10.4137/ccrep.s32121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/21/2015] [Accepted: 09/27/2015] [Indexed: 11/18/2022]
Abstract
In this report, we describe the case of an end-stage kidney disease patient with tetralogy of Fallot (TOF). A 33-year-old female with TOF was admitted to our hospital with complaints of general fatigue and appetite loss probably due to uremic milieu. She was ultimately treated with peritoneal dialysis (PD) with a favorable clinical course. TOF patients with chronic kidney disease are not exceptional, although the currently available information regarding the association between TOF and renal failure severe enough to require dialysis treatment is limited. We also discuss the complex processes of how and why PD was selected as a mode of chronic renal replacement therapy in this case.
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Affiliation(s)
- Ken Ohara
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Tetsu Akimoto
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Takuya Miki
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Naoko Otani
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Taro Sugase
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Takahiro Masuda
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Takuya Murakami
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Toshimi Imai
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Shin-Ichi Takeda
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Yasuhiro Ando
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Shigeaki Muto
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
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