View clinical trials related to Arterio-Venous Fistula.
Filter by:We wish to examine Arterio-Venous Fistula (AVF) and Arterio-Venous Graft (AVG) utilisation rates for Haemodialysis at University Hospital Limerick. We want to determine out of the AVF's that are surgically created, how many go on to be used as anticipated for haemodialysis treatments successfully.
Preoperative vascular mapping with echo-Doppler is acknowledged as indispensable to create an arteriovenous fistula for haemodialysis (AVF). The conditions for performing this examination are not always ideal (venous vasospasm in cool temperatures, variability of the volume status in the dialysis patient). On the other hand, the use of a loco-regional anaesthesia (LRA) results in the vasodilation of the limb thus rendering it possible to use the veins which were initially considered too small. The aim of this study is to assess the functionality of our AVF when ultrasound identification was used by the surgeon after the LRA. These results have been compared with those of the preceding year during which this identification was not implemented.
In recent years, applications designed specifically to encourage physical activity in the field of mobile technology have gained momentum. As a result of the literature research, no examples of mobile health applications developed with educational content on fistula care, which hemodialysis-dependent patients can reach at any time and place, have not been found. Based on this, it was planned to increase the knowledge level of arteriovenous fistula care and examine their self-care behaviors and their adaptation to the disease with the mobile application developed with a focus on education on fistula care, which can be used independently by machine-dependent hemodialysis patients. In this context, it is aimed that dialysis patients will benefit especially in arteriovenous fistula care applications, thanks to the ever-increasing mobile applications in daily use with the developing technology. It is thought that the use of these technology-based trainings will be more comfortable, useful and encouraging for their own self-care. It is planned to be a guide for healthcare professionals.
The surgical formation of an AVF offers a unique example of vascular remodelling and adaption. Yet, the specific factors which elicit remodelling events which determine successful maturation or failure have not been unambiguously determined. Computational fluid dynamic (CFD) simulations are increasingly been employed to investigate the interaction between local haemodynamics and remodelling and can potentially be used to assist in clinical risk assessment of maturation or failure. However, these simulations are inextricably linked to their prescribed boundary conditions and are reliant on in vivo measurements of flow and pressure to ensure their validity. This study will compare in vivo measurements of the pressure distribution across an AVF against a representative numerical model.
End-stage renal disease (ESRD) arises from many heterogeneous disease pathways that alter the function and structure of the kidney irreversibly, over months or years.End-stage renal disease (ESRD) arises from many heterogeneous disease pathways that alter the function and structure of the kidney irreversibly, over months or years. Haemodialysis (HD) is a lifeline therapy for patients with ESRD. Our study to compare methods of AVF creation, side to side and end to side . This randomized controlled trial .
The study is planed on ASA I-III, 18-80 years old 60 patients developing chronic renal failure and needing arteriovenous fistula surgery for dialysis program in Istanbul Medeniyet University Goztepe Research Hospital. Informed consent of the patients will be obtained before surgery.Patients with hemoglobinopathy, coagulopathy, wound or infection in the thenar eminence, wound and infection in the supraclavicular region on the side of the regional block, allergic to local anesthetic drugs and mental retardation will not be included in the study. Standart monitorization (ECG, peripheral oxygen saturation and non-invasive arterial pressure monitoring) will be made. Base and 5 minutes interval values will be recorded until the end of the surgery. The pads of the NIRS monitor will be placed on the thenar eminence of both hands and fixed with the help of a draipe and basal measurements will be taken and recorded. The patients will then be divided into two groups according to computer-generated table of random numbers. Group L patients will undergo surgical cleansing and sterile draping and infiltrate %5 bupivacaine 15ml. Group B the supraclavicular areas of the patients who will undergo surgical procedures will be sterile covered after appropriate sterilization. After the brachial plexus is visualized around the subclavian artery in the supraclavicular region with the help of Samsung ultrasound device, Bupivacaine 5% 20ml and Lidocaine 2% 10ml will be applied around the brachial plexus using a 50mm stimuplex needle. The effectiveness of the block will be evaluated by a single investigator after withdrawal of the needle, either by effective anesthesia with the block or every 10 minutes up to 30 minutes. The sensory block will be evaluated with a 3 point scale and the motor block will be evaluated routinely before and after the modified bromage scale (scored between 0 and 4). After withdrawal of the treated needle, we will contact the relevant nerve dermatome with cold application (cold SF) and ask the patient to classify the degree of cold feeling from 0 to 3. Block will be considered unsuccessful if surgical block cannot be provided after 30 minutes or if the patient experiences pain at any time during the operation. The duration of anesthesia occurring after local infiltration of Group L and the sensory and motor blockade after group B stimulation is taken will be recorded. In both groups, NIRS values will be recorded at 5 minute intervals until the end of the case after local anesthetic application. Investigator will call the patients for primer patency of fistula one month after operation.
The number of hemodialysis patients in the world are increasing. In order to receive a sufficient dialysis, the patients needs a well functioning and stable vascular access - preferably an arteriovenous fistula (AVF). Unfortunately, the AVF has a high incidence of stenosis with percutaneous trans luminal angioplasty (PTA) as the only treatment option and a short lifetime. Little do we know of how to improve the survival of the AVF. With this study we want to explore the effect of far infrared therapy on the stenosis, maturation and survival of the arteriovenous fistula. The investigators will divide the patients into 2 groups: A treatment group and a control group. The treatment group will receive infrared therapy on their fistula during their dialysis session. The control group will not receive any infrared therapy. The investigators hope to reduce the risk of stenosis in the fistula and improve the fistula survival with this treatment. Furthermore, the investigators want to explore the change in several biochemical markers during the treatment with infrared therapy.
For chronic hemodialysis patients, the creation of a well-functioning arteriovenous (AV) fistula is critical for ensuring that patient receive adequate hemodialysis. Unfortunately, the primary failure rate for AV fistulas after surgery is about 40%, and this percentage has not changed despite a number of trials of pharmaceutical agents and biologic agents. A key to success in the development of a useable AV fistula is an adequate arterial and venous diameter in the access forearm. Although exercise is commonly used to increase vessel diameter after AV fistula placement, Investigators are unaware of published studies that report on the effect of exercise prior to AV fistula placement to assist with the maturation of a newly created AV fistula. In this pilot trial, the Principal Investigator will evaluate the feasibility and possible benefits of pre-surgical exercise on forearm AV fistulas.
This is a prospective single arm study enrolling patients who are scheduled for creation of a new Brachiocephalic or Radiocephalic AV fistula. Up to 80 patients will be enrolled, 50 with upper arm AV fistula and 30 with forearm AV fistula. All patients will be implanted with the VasQ device, a subcutaneous arteriovenous conduit support for vascular access. The follow up period in this study will be for a duration of 12 months, with follow up visits scheduled at 1, 3, 6, 9, and 12 months.
This is a prospective clinical study of the VasQ external support for arteriovenous fistulas. The device is designed to improve fistula outcomes by optimizing the geometrical configuration of the fistula, influencing hemodynamics, minimizing turbulence and promote laminar flow. All patients will be implanted with the VasQ device and will be followed up for a duration of 24 months.