- Email: [email protected]
Arterial Stiffness and Arteriovenous Fistula Outcomes
Eur J Vasc Endovasc Surg (2016) 52, e73ee78
Abstracts presented at the IAVS & NIVASC Joint Annual Meeting 2016 Arterial Stiffness and Arteriovenous Fistula Outcomes D.G. McGrogan 1,4, G. McKevitt 1, S. Stringer 2, P. Cockwell 2, M. Jesky 2, C. Ferro 2, A.P. Maxwell 3, N.G. Inston 4 1
Department of Vascular Surgery, Belfast Health and Social Care Trust, Royal Victoria Hospital, Grosvenor Road, Belfast, UK 2 Department of Nephrology, University Hospitals Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK 3 Regional Nephrology Unit, Belfast Health and Social Care Trust, Belfast City Hospital, 51 Lisburn Road, Belfast, UK 4 Department of Vascular Access and Renal Transplantation, University Hospitals Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
Introduction: Poor arteriovenous fistula (AVF) outcomes can be caused by early thrombosis and most studies of AVF maturation have focused on venous outflow and neointimal hyperplasia. The aim of this investigation was to evaluate the relationship between arterial disease and early postoperative AVF outcomes using an observational cohort study of end stage renal disease (ESRD) patients assessed for parameters of arterial disease. Methods: The Renal Impairment In Secondary Care (RIISC) study is a prospective, observational cohort study, comprising patients with ESRD. Primary AVF failure (PFL) was defined as thrombosis at six week review. All patients underwent BP Tru and Vicorder pulse wave analysis assessments and also had skin auto-fluorescence for assessment of advanced glycation end-product deposition prior to AVF formation. Results: A total of 108 AVFs were created in 86 patients. The primary function (PFN) group was compared to the PFL group. The PFN group had a higher body mass index (BMI) (p¼0.01). Intraluminal vein diameter was significantly greater in the PFN (p¼<0.01). There were significant differences between groups for the following non-invasive arterial measurements: mean augmentation index and augmentation index 75 as measured by central arterial pulse wave analysis was significantly higher in the PFN group (p¼0.03 and 0.03 respectively). Conclusion: All patients in this ESRD cohort have significant aortic stiffness. Non-invasive arterial parameters are associated with PFN and can be used to inform the risk of PFN in patients who undergo AVF formation. Further studies are required to validate these observations. Initial Experience with Mechanochemical Endovenous Ablation in the Treatment of Primary Varicose Veins M. Wynne, M.M. Popp-Mittal, F.M. Shaikh, S.R. Walsh Department of Vascular Surgery, Galway University Hospital, Galway, Ireland
Introduction: Recently catheter-based, endovenous ablation has emerged as a minimally invasive alternative to the traditional treatment of varicose veins. ClariVeinÒ is a newly developed device which uses a technique that
combines mechanical endothelial damage using a rotating wire with the infusion of a liquid sclerosant. Our aim was to study the efficacy and safety of the technique in the treatment of primary varicose veins. Methods: A retrospective analysis was performed of all consecutive procedures treated for primary varicose vein, carried out from July 2015 to February 2016 using the ClariVein. Patients were pre assessed with history, physical exam and duplex ultrasound. Patients were followed in outpatients department at 6 weeks with the duplex and asked to fill a questionnaire regarding procedure satisfaction. Results: A total of 90 patients (121 legs) underwent mechano-chemical ablation using the ClariVein device. Mean age of patients were 57.7 years. There were 26 men and 74 women, all procedures were performed in day ward settings under local anesthesia at the insertion site of the catheter with an assistant nurse and surgeon. 32 patients have bilateral leg varicose veins treated simultaneously. There was no case of major adverse event including DVT or stroke. Duplex occlusion rate was over 90%. Procedure satisfaction rate was over 95%. Conclusion: Mechano-chemical occlusion using ClariVeinÒ has proven to be safe and effective in the treatment of primary varicose veins. Procedure can be safely performed in day ward settings with minimum staff with excellent results without compromising patient’s safety and satisfaction.
Fate of Immediately Failed Angioplasty for Infra-inguinal Arterial Disease E.A.H. Kheirelseid, S. Angelov, A. Elmallah, E. Boyle, D. Power, A. O’Callaghan, Z. Martin, S.M. O’Neill, M.P. Colgan, P. Madhavan Department of Vascular and Endovascular Surgery, St James’s Hospital, Dublin, Ireland
Background: Peripheral angioplasty for arterial disease is associated with low morbidity and mortality, short hospital stay and reduced cost. Concern exists about possible compromise of future bypass options if required. The objectives of this study were to determine the fate of the immediately failed angioplasty in our cohort of patients. Methods: Data was acquired from review of medical records and a prospectively maintained database between 2000 and 2015. Over the study period 1713 procedures were carried out on 1356 limbs in 1195 patients. SPSS was used for data analysis. Results: Over the study period angioplasty failed in 153 procedures (8.9%) on 128 legs (9.4%). The indications were acute ischemia (3.9%), claudication (5.5%), rest pain (13.3%) and tissue loss (77.3%). Of failed angioplasty, 10.2% needed no further intervention and 50.7% had bypass procedure. Amputation was performed in 52 legs (40.6%). Of them, 49
Abstracts presented at the IAVS & NIVASC Joint Annual Meeting 2016 Arterial Stiffness and Arteriovenous Fistula Outcomes D.G. McGrogan 1,4, G. McKevitt 1, S. Stringer 2, P. Cockwell 2, M. Jesky 2, C. Ferro 2, A.P. Maxwell 3, N.G. Inston 4 1
Department of Vascular Surgery, Belfast Health and Social Care Trust, Royal Victoria Hospital, Grosvenor Road, Belfast, UK 2 Department of Nephrology, University Hospitals Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK 3 Regional Nephrology Unit, Belfast Health and Social Care Trust, Belfast City Hospital, 51 Lisburn Road, Belfast, UK 4 Department of Vascular Access and Renal Transplantation, University Hospitals Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
Introduction: Poor arteriovenous fistula (AVF) outcomes can be caused by early thrombosis and most studies of AVF maturation have focused on venous outflow and neointimal hyperplasia. The aim of this investigation was to evaluate the relationship between arterial disease and early postoperative AVF outcomes using an observational cohort study of end stage renal disease (ESRD) patients assessed for parameters of arterial disease. Methods: The Renal Impairment In Secondary Care (RIISC) study is a prospective, observational cohort study, comprising patients with ESRD. Primary AVF failure (PFL) was defined as thrombosis at six week review. All patients underwent BP Tru and Vicorder pulse wave analysis assessments and also had skin auto-fluorescence for assessment of advanced glycation end-product deposition prior to AVF formation. Results: A total of 108 AVFs were created in 86 patients. The primary function (PFN) group was compared to the PFL group. The PFN group had a higher body mass index (BMI) (p¼0.01). Intraluminal vein diameter was significantly greater in the PFN (p¼<0.01). There were significant differences between groups for the following non-invasive arterial measurements: mean augmentation index and augmentation index 75 as measured by central arterial pulse wave analysis was significantly higher in the PFN group (p¼0.03 and 0.03 respectively). Conclusion: All patients in this ESRD cohort have significant aortic stiffness. Non-invasive arterial parameters are associated with PFN and can be used to inform the risk of PFN in patients who undergo AVF formation. Further studies are required to validate these observations. Initial Experience with Mechanochemical Endovenous Ablation in the Treatment of Primary Varicose Veins M. Wynne, M.M. Popp-Mittal, F.M. Shaikh, S.R. Walsh Department of Vascular Surgery, Galway University Hospital, Galway, Ireland
Introduction: Recently catheter-based, endovenous ablation has emerged as a minimally invasive alternative to the traditional treatment of varicose veins. ClariVeinÒ is a newly developed device which uses a technique that
combines mechanical endothelial damage using a rotating wire with the infusion of a liquid sclerosant. Our aim was to study the efficacy and safety of the technique in the treatment of primary varicose veins. Methods: A retrospective analysis was performed of all consecutive procedures treated for primary varicose vein, carried out from July 2015 to February 2016 using the ClariVein. Patients were pre assessed with history, physical exam and duplex ultrasound. Patients were followed in outpatients department at 6 weeks with the duplex and asked to fill a questionnaire regarding procedure satisfaction. Results: A total of 90 patients (121 legs) underwent mechano-chemical ablation using the ClariVein device. Mean age of patients were 57.7 years. There were 26 men and 74 women, all procedures were performed in day ward settings under local anesthesia at the insertion site of the catheter with an assistant nurse and surgeon. 32 patients have bilateral leg varicose veins treated simultaneously. There was no case of major adverse event including DVT or stroke. Duplex occlusion rate was over 90%. Procedure satisfaction rate was over 95%. Conclusion: Mechano-chemical occlusion using ClariVeinÒ has proven to be safe and effective in the treatment of primary varicose veins. Procedure can be safely performed in day ward settings with minimum staff with excellent results without compromising patient’s safety and satisfaction.
Fate of Immediately Failed Angioplasty for Infra-inguinal Arterial Disease E.A.H. Kheirelseid, S. Angelov, A. Elmallah, E. Boyle, D. Power, A. O’Callaghan, Z. Martin, S.M. O’Neill, M.P. Colgan, P. Madhavan Department of Vascular and Endovascular Surgery, St James’s Hospital, Dublin, Ireland
Background: Peripheral angioplasty for arterial disease is associated with low morbidity and mortality, short hospital stay and reduced cost. Concern exists about possible compromise of future bypass options if required. The objectives of this study were to determine the fate of the immediately failed angioplasty in our cohort of patients. Methods: Data was acquired from review of medical records and a prospectively maintained database between 2000 and 2015. Over the study period 1713 procedures were carried out on 1356 limbs in 1195 patients. SPSS was used for data analysis. Results: Over the study period angioplasty failed in 153 procedures (8.9%) on 128 legs (9.4%). The indications were acute ischemia (3.9%), claudication (5.5%), rest pain (13.3%) and tissue loss (77.3%). Of failed angioplasty, 10.2% needed no further intervention and 50.7% had bypass procedure. Amputation was performed in 52 legs (40.6%). Of them, 49