Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

O’Reilly, Martin; Ryan, Dene E.; Sugrue, Gavin; Geoghegan, Tony; Lawler, Leo P.; Farrelly, Cormac

doi:10.1007/s00270-016-1428-9

Cited by 3 publications

(7 citation statements)

References 10 publications

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“…Autologous arteriovenous istula (AVF) is accepted as the most effective and durable route for haemodialysis. However, complications such as stenosis and occlusion can be quite frequent [1]. In the treatment of stenotic or occlusive AVF complications, endovascular recanalization has an important role due to its minimally invasive nature and effective results [2].…”

Section: Introductionmentioning

confidence: 99%

“…One of the most important technique used in the treatment of acute thrombosis is the manual aspiration thrombectomy through a large-bore venous sheath along with high dose heparinization. Therefore, haemorrhagic complications such as bleeding and haematoma can be seen more frequently after the sheath removal [1,3,4]. These local complications can occur frequently in daily practice but are currently underreported in the literature [5].…”

Section: Introductionmentioning

confidence: 99%

“…However, it takes at least 15 minutes to achieve haemostasis, and this time can be prolonged due to use of large-bore venous sheaths and heparin dose can further prolong achievement of haemostasis [1,6]. Additionally, since the digital pressure at a certain and consistent degree is hard to maintain for a long time, inappropriate pressure can also lead to rethrombosis or haemorrhage [1,3,6]. Various procedures for achieving haemostasis were described in the literature previously [1,3,4,6].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, since the digital pressure at a certain and consistent degree is hard to maintain for a long time, inappropriate pressure can also lead to rethrombosis or haemorrhage [1,3,6]. Various procedures for achieving haemostasis were described in the literature previously [1,3,4,6]. A primitive suture-based technique was initially used by U lacker, et al as a single skin suture under digital compression [7].…”

Section: Introductionmentioning

confidence: 99%

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Haemostasis with suture-tourniquet technique following removal of large-bore venous sheaths for endovascular recanalization of acute thrombosis in native arteriovenous fistula

Ballı¹

2019

J Radiol Oncol

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Purpose: To investigate the suture-tourniquet technique for haemostasis in patients with acute thrombosis of native arteriovenous fi stula (AVF) whom underwent manual aspiration thrombectomy using large-bore venous sheaths and high dose heparin. , patients with acute AVF thrombosis performed successful manual aspiration thrombectomy by using large bore venous sheaths and high dose heparin were included in this retrospective study. Success rate for haemostasis, procedural complications clinical and imaging follow up was reported descriptively.Results: A total of 52 patients with 64 procedures met the inclusion criteria. In 60(94%) of 64 procedures, successful haemostasis was achieved with suture-tourniquet technique. In 2(3.1%) of the 64 procedures, the suture broke while turning the tourniquet and haematoma occurred in another 3 procedures (4.7%) although suture-tourniquet technique was applied appropriately. Manual compression was performed in these patients. There were 3 major complications unrelated the suture-tourniquet technique. Conclusion:The suture tourniquet technique can achieve haemostasis rapidly and can be safely used with low complication rates without fi stulae thrombosis after large-bore venous sheath removal following treatment of AVF thrombosis.How to cite this article: Balli O. Haemostasis with suture-tourniquet technique following removal of large-bore venous sheaths for endovascular recanalization of acute thrombosis in native arteriovenous fi stula.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Haemostasis with suture-tourniquet technique following removal of large-bore venous sheaths for endovascular recanalization of acute thrombosis in native arteriovenous fistula

Ballı¹

2019

J Radiol Oncol

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“…To the editor, We read with great interest the recent article by O'Reilly et al on the use of a pneumatic compression device for haemostasis following fistula access procedures [1]. At our institution, we have used a Safeguard Radial Compression device (Merit Medical Systems Inc.) for haemostasis after arteriovenous fistula and graft procedures for a number of years, frequently after use of a 7 Fr sheath access.…”

mentioning

confidence: 99%

Re: Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

Conroy

Hanko

Lindsay

2017

Cardiovasc Intervent Radiol

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Safety of bilateral arm pressure measurements in the diagnostic workup of dialysis-associated steal syndrome

Benfor,

Bohle,

Peden

2023

J Vasc Access

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Objective: Although bilateral brachial pressure measurement is routinely included in the diagnostic work-up of upper extremity ischemia, it is generally avoided in the presence of hemodialysis access due to fears of inducing access thrombosis. This study evaluated the safety of bilateral brachial pressure measurement in patients with clinical suspicion of dialysis-associated steal syndrome (DASS). Methods: Patients undergoing non-invasive testing for steal syndrome between September 2015 and December 2021 were included in this study. The diagnostic workup was performed by certified vascular sonographers in an outpatient vascular lab and consisted of bilateral brachial pressures, photoplethysmography, and duplex ultrasonography of the access. Interarm differential (IAD) was defined as systolic blood pressure (SBP) in the contralateral arm minus SBP in the access arm. The primary endpoint was immediate access thrombosis. Results: The study sample consisted of 331 subjects with a mean age of 61 ± 13 and a median access age of 9 months (3–31 months) with radiocephalic fistulas present in 29%. Many patients (68%) presented with paresthesia and 4% presented with tissue loss. The mean brachial systolic pressure was 152 ± 37 mmHg on the ipsilateral arm versus 143 ± 34 mmHg on the contralateral ( p-value <0.001), with an inter-arm differential (IAD) of −8.4 ± 19 mmHg. A total of 16 subjects (5%) presented a differential ⩾20 mmHg. A positive thrill was noted in all the accesses immediately following blood pressure measurement and no occurrence of access thrombosis was noted at 30 days. Proximal arterial revascularization interventions were performed in 11 cases (3%). Subjects who presented an IAD ⩾20 mmHg had lower ipsilateral digital-brachial index (0.39 ± 0.18 vs 0.68 ± 0.26; p = 0.037), a higher tendency of being referred for angiograms (37.5% vs 10.5%, p = 0.006), and more proximal arterial revascularization procedures (25.0% vs 2.2%, p = 0.001). Conclusion: Bilateral arm pressure measurement in the context of dialysis access-associated steal syndrome (DASS) appears safe and useful for identifying subjects whose symptoms are due to proximal arterial inflow disease. We therefore recommend this test be considered in the diagnostic algorithms of DASS.

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Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

Abstract: Haemostasis of arterio-venous haemodialysis fistula access sites can be safely and effectively achieved using a pneumatic compression device. This is a technically simple, safe and sutureless technique for acquiring haemostasis after AVF intervention.

Cited by 3 publications

References 10 publications

Haemostasis with suture-tourniquet technique following removal of large-bore venous sheaths for endovascular recanalization of acute thrombosis in native arteriovenous fistula

Haemostasis with suture-tourniquet technique following removal of large-bore venous sheaths for endovascular recanalization of acute thrombosis in native arteriovenous fistula

Re: Novel Use of a Pneumatic Compression Device for Haemostasis of Haemodialysis Fistula Access Catheterisation Sites

Safety of bilateral arm pressure measurements in the diagnostic workup of dialysis-associated steal syndrome

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