Contrast Venography Versus Intravenous Ultrasound in Hemodialysis Arteriovenous Access Dysfunction.
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SUBMITTER: Idrees N
PROVIDER: S-EPMC10496077 | biostudies-literature | 2023 Sep
REPOSITORIES: biostudies-literature
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Contrast Venography Versus Intravenous Ultrasound in Hemodialysis Arteriovenous Access Dysfunction.
Idrees Najia N Haroon Samir S Zhang Yichi Y Mangio Joanna Crisa JC Siracuse Jeffrey J JJ Francis Jean M JM Ganguli Suvranu S Daly Kevin K Diamond Matthew M Vilvendhan Rajendran R Cabral Howard H Dember Laura M LM Farber Alik A Kolachalama Vijaya B VB Chitalia Vipul C VC
Kidney international reports 20230617 9
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Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. In the present study efficacy of Human AMSCs transplantation in treating AVF failure was tested in FoxN1 Nude mice with surgically created AVF. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice 3 days after adventitial transplantation of MSCs.
2025-07-07 | GSE223511 | GEO
Project description:This SuperSeries is composed of the SubSeries listed below.
2025-07-07 | GSE179959 | GEO
Project description:BackgroundIt is unclear whether surgical placement of an arteriovenous (AV) fistula (AVF) confers substantial clinical benefits over an AV graft (AVG) in older adults with end-stage kidney disease (ESKD). We report vascular access outcomes of a pilot clinical trial.Study designPilot randomized parallel-group open-label trial.Setting & participantsPatients 65 years and older with ESKD and no prior AV access receiving maintenance hemodialysis through a tunneled central venous catheter referred for AV access placement by their treating nephrologist.InterventionParticipants were randomly assigned in a 1:1 ratio to surgical placement of an AVG or AVF.OutcomesIndex AV access primary failure, successful cannulation, adjuvant interventions and infections.ResultsOf 122 older adults receiving hemodialysis and no prior AV access surgery, 24% died before (n = 18) or were too sick for (n = 11) referral for a permanent AV access. Of 46 eligible patients, 36 (78%) consented and were randomly assigned to AVG (n = 18) and AVF (n = 18) placement, of whom 13 (72%) and 16 (89%) underwent index AV access surgical placement, respectively. At a median follow-up of 321.0 days, primary AV access failure was noted in 31% in each group. The proportion of patients with successful cannulation was 62% (8 of 13) in the AVG and 50% (8 of 16) in the AVF group; median times to successful cannulation were 75.0 and 113.5 days, respectively. Endovascular procedures were recorded in 38% and 44%, and surgical reinterventions, in 23% and 25%, respectively. AV access infection was seen in 3 (23%) and 2 (13%) patients, respectively.LimitationsSmall sample size precludes statistical inference.ConclusionsAlmost one-quarter of older adults with incident ESKD and a central venous catheter as primary access were not referred for AV access placement due to medical reasons. Based on these limited results, there is little reason to favor either an AVF or AVG in this population until results from a larger randomized clinical trial become available.FundingGovernment funding to an author (Dr Murea is supported by National Institutes of Health∖National Institute on Aging grant 1R03 AG060178-01).Trial registrationNCT03545113.
| S-EPMC8039401 | biostudies-literature
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179957 | GEO
Project description:ObjectiveThe objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches.MethodsBlood flow rates in the proximal artery (PA) and draining vein (DV) of newly created upper extremity AVFs were measured and compared using DUS and phase-contrast MRI at 1 day, 6 weeks, and 6 months postoperatively.ResultsBlood flow rates in the PA measured by DUS (1155 ± 907 mL/min, mean ± standard deviation) and by MRI (1170 ± 657 mL/min) were not statistically different (P = .812) based on 78 data pairs from 49 patients. DV DUS flow (1277 ± 995 mL/min) and MRI flow (1130 ± 655 mL/min) were also not statistically different (P = .071) based on 64 data pairs. In both PA and DV, the two methods substantially agreed with each other (Cohen κ: PA, 0.66; DV, 0.67) when flow rates were put into four clinically relevant categories (<300, 300-599, 600-1499, and ≥1500 mL/min). The Bland-Altman analyses of DUS and MRI flow identified six and four outliers for PA and DV, respectively. Seven outliers had higher DUS than MRI flow, with all DUS scan sites having a large lumen or significant local curvature; the other three had lower DUS flow, partly due to an underestimation of lumen diameter by DUS.ConclusionsDUS and MRI flow rates are generally comparable in both PA and DV. When DUS is used for flow measurements, careful attention to accurate lumen diameter measurements is needed and scan sites with marked curvature should be avoided. Our result may improve the accuracy of DUS-measured AVF blood flow rate.
| S-EPMC6240398 | biostudies-literature
Project description:Rationale and objectiveThis study aimed to develop a cosmesis scale to evaluate the cosmetic appearance of hemodialysis (HD) arteriovenous (AV) accesses from the perspective of the patient and clinician, which could be incorporated into clinical trials.Study designUsing a modified Delphi process, two AV access cosmesis scale (AVACS) components were developed in a four-round Delphi panel consisting of two surveys and two consensus meetings with two rounds of patient consultation.Setting and participantsThe Delphi panel consisted of 15 voting members including five interventional or general nephrologists, five vascular surgeons, three interventional radiologists, and two vascular access nurse coordinators. Four patients experienced with vascular access were involved in patient question development.Analytical approachFor a component to be included in the AVACS, it had to meet the prespecified panel consensus agreement of ⩾70%.ResultsThe clinician component of the AVACS includes nine questions on the following AV access features: scarring, skin discoloration, aneurysm/pseudoaneurysms and megafistula appearance. The patient component includes six questions about future vascular access decisions, interference with work or leisure activities, clothing choices, self-consciousness or attractiveness, emotional impact, and overall appearance.LimitationsDelphi panel methods are subjective by design, but with expert clinical opinion are used to develop classification systems and outcome measures. The developed scale requires further validation testing but is available for clinical trial use.ConclusionsWhile safety and efficacy are the primary concerns when evaluating AV access for HD, cosmesis is an important component of the ESKD patient experience. The AVACS has been designed to assess this important domain; it can be used to facilitate patient care and education about vascular access choice and maintenance. AVACS can also be used to inform future research on developing new techniques for AV access creation and maintenance, particularly as relates to AV access cosmesis.
| S-EPMC11308273 | biostudies-literature
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179955 | GEO
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.
2025-07-07 | GSE179954 | GEO
Project description:Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing hemodialysis and the majority of AVFs fail because of venous intimal hyperplasia (VNH). Results from our lab have shown that adipose tissue-derived mesenchymal stem cell (MSC) transplantation to the adventitia of the outflow vein of AVF attenuates VNH in an immunodeficient mice. in the present study efficacy of AMSCs transplantation in treating AVF failure was tested in a chronic kidney disease (CKD) followed by an AVF created in C57BL/6 mice and porcine models as described in methods. Moreover, a phase 1 trial was performed in small group of endstage renal disease (ESRD) patients who are in hemodialysis. To explore the molecular mechanisms involved in MSCs transplantation improving AVF durability, we performed RNA-seq transcriptome analysis of the outflow veins of AVFs excised from mice and Pigs the after adventitial transplantation of MSCs from the donor inbred C57BL/6 mice or pigs respectively. RNA-seq on AMSCs isolated from donor mice, pigs and from patients of Phase 1 study was performed and CD markers of MSCs were compared to assess the homogenicity of isolated AMSCs with in the species.Mesenchymal Stem Cell Transplantation Attenuates Venous Stenosis of Hemodialysis Vascular Access Arteriovenous Fistula
2025-07-07 | GSE179953 | GEO
Project description:In hemodialysis, vascular access is a key issue. The preferred access is an arteriovenous fistula on the non-dominant lower arm. If the natural vessels are insufficient for such access, the insertion of a synthetic vascular graft between artery and vein is an option to construct an arteriovenous shunt for punctures. In emergency situations and especially in elderly with narrow and atherosclerotic vessels, a cuffed double-lumen catheter is placed in a larger vein for chronic use. The latter option constitutes a greater risk for infections while arteriovenous fistula and arteriovenous shunt can fail due to stenosis, thrombosis, or infections. This review will recapitulate the vast and interdisciplinary scenario that characterizes hemodialysis vascular access creation and function, since adequate access management must be based on knowledge of the state of the art and on future perspectives. We also discuss recent developments to improve arteriovenous fistula creation and patency, the blood compatibility of arteriovenous shunt, needs to avoid infections, and potential development of tissue engineering applications in hemodialysis vascular access. The ultimate goal is to spread more knowledge in a critical area of medicine that is importantly affecting medical costs of renal replacement therapies and patients' quality of life.
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