A5008237152- Central Venous Catheters and Hemodialysis
- Vascular Procedures and Complications
- Vascular anomalies and interventions
- Cardiac Arrhythmias and Treatments
- Dialysis and Renal Disease Management
- Peripheral Artery Disease Management
- Renal and Vascular Pathologies
- Vascular Malformations Diagnosis and Treatment
- Peripheral Nerve Disorders
- Electronic and Structural Properties of Oxides
- Acute Kidney Injury Research
- Coronary Interventions and Diagnostics
- Pain Management and Treatment
- Infectious Aortic and Vascular Conditions
- Cardiac pacing and defibrillation studies
- Vascular Malformations and Hemangiomas
- Diagnosis and Treatment of Venous Diseases
- Cardiac Valve Diseases and Treatments
Kansai Rosai Hospital
2016-2025
Osaka Police Hospital
2025
Kinki Central Hospital
2014-2015
PurposeTo present the 12-month outcomes of IN.PACT AV Access Study, a prospective, single-blind trial enrolling participants with obstructive de novo or restenotic native upper extremity arteriovenous dialysis fistula lesions treated drug-coated balloon (DCB) percutaneous transluminal angioplasty (PTA).Materials and MethodsAfter successful high-pressure PTA, at 29 international sites were randomized 1:1 to treatment an DCB (n = 170) standard uncoated PTA 160). Outcomes 12 months include...
Objective: This study aimed to evaluate the effectiveness of a drug-coated balloon (DCB) for treatment dysfunctional arteriovenous fistulas (AVFs) and identify risk factors associated with early late losses primary patency following DCB in real-world practice. Methods: multicenter, retrospective included 407 patients (72 ± 11 years, 64.1% males) AVFs (juxta-anastomotic lesion location 58.7% cases, mean size 1.2 mm, length 54 mm) who underwent first time AVF. The outcome measure was loss...
To present the 36-month outcomes of prospective randomized IN.PACT AV Access study participants with obstructive de novo or restenotic native upper extremity arteriovenous dialysis fistula lesions treated drug-coated balloon (DCBs) standard percutaneous transluminal angioplasty (PTA) following successful high-pressure PTA. Participants at 29 international sites were 1:1 to receive an DCB (n = 170) undergo PTA 160). The through 36 months included target lesion primary patency (TLPP) and...
Purpose: To investigate if morphological patterns of arteriovenous fistula (AVF) venous lesions affect primary patency after percutaneous transluminal angioplasty (PTA). Methods: From July 2014 to June 2015, 262 patients underwent PTA for failed AVFs. A total 104 were excluded owing (1) calcification or AVF occlusion precluding ultrasound examination, (2) central arterial lesions, and (3) no follow-up, leaving 158 (mean age 71±12; 96 men) analysis. More than half the had one more previous...
Purpose: To assess 6-month safety and efficacy of a self-expanding stent graft placement to treat stenotic or thrombosed synthetic arteriovenous access at the venous anastomoses. Material methods: This prospective, multicenter, post-market surveillance study assessed GORE ® VIABAHN Endoprosthesis (stent graft) in Japanese patients with vascular grafts. Key outcomes were primary patency (PP) secondary (SP) target lesion circuit, repeat interventions, technical clinical success, incidence...
Purpose Percutaneous transluminal angioplasty (PTA) is the first-line treatment for vascular access stenosis. To our knowledge, multicenter clinical research of PTA has not been reported in Japan. We examined efficacy and safety arteriovenous fistula (AVF) graft (AVG) five centers Methods Three hundred cases AVF 300 AVG were three each. A consecutive patients from each center who underwent or prior to March 2014 met inclusion criteria searched retrospectively. Primary patency rates estimated...
There is a lack of adjudicated and prospectively randomized published outcomes on the use drug-coated balloons (DCB) to treat dysfunctional arteriovenous fistula in Asian patients. This post hoc subgroup analysis 112 Japanese participants from global IN.PACT AV Access trial reports through 12 months.Participants were treated with DCB (n = 58) or standard non-coated percutaneous transluminal angioplasty (PTA) 54). Outcomes included target lesion primary patency (TLPP), access circuit patency,...
An arteriovenous fistula (AVF) is considered the gold standard modality of vascular access (VA) for maintenance hemodialysis (HD) because its superior patency, few complications, provision high quality life, and low risk patient mortality. The rapid growth aging population prevalence comorbidities, particularly diabetes mellitus peripheral disease, in patients requiring HD inevitably deteriorate ability to construct maintain a conventional AVF these patients' insufficient adaptability....
<b><i>Background:</i></b> Most guidelines recommend the creation of arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD) stage 4. However, an increasing number studies suggest that early AVF leads to high rates failure and death before dialysis commencement. Only Japanese guideline recommends at CKD 5; however, no data are available regarding access-related outcomes this stage. <b><i>Method:</i></b> This was a multicenter...
We implanted a fluoropolymer-based paclitaxel-eluting stent (FP-PES) in four hemodialysis patients with refractory outflow venous stenosis of their arteriovenous graft. The mean observation period after FP-PES implantation was 11.5 ± 4.7 months (range, 7.0-18.0 months). After implantation, the were evaluated by ultrasound every 3 months. No experienced neointimal hyperplasia stents during period, and no reintervention performed. FP-PESs could be an attractive alternative to percutaneous...
A fluoropolymer-based drug-eluting stent was implanted in an arteriovenous graft outflow venous stenosis. Two and a half years later, due to local infection, the removed surgically, pathological evaluation conducted. The struts exhibited partial endothelial cell coverage, with remaining surface predominantly covered by fibrin. Notably, there no evidence of restenosis or aneurysmal change.
近年，バスキュラーアクセス（vascular access: VA）に対する超音波検査が普及している．その主な検査目的は，作製前の血管評価と作製後におけるVAの状態や合併症の評価である．作製前においては，血管径や血管壁の性状，連続性などを観察し，自己血管内シャントや人工血管内シャント，動脈表在化などの術式の判断に用いられる．第一選択は自己血管内シャントであるが，表在静脈荒廃などの理由で作製が困難と判断される場合は，人工血管内シャントや動脈表在化も考慮する．最終的には動脈と静脈を吻合すると，どのような血行動態を示すVAになりうるかを考えることが重要である．VA作製後，恒久的にそれが維持できれば良いが，大部分は何らかの合併症を発症する．最も多いのは，狭窄病変の発現であり，その進行により閉塞に至る．閉塞すれば治療の成功率も低下することから，可能な限り狭窄の段階で適切な時期に治療介入することが理想的である．そこで，超音波パルスドプラ法を用いた血流量や末梢血管抵抗指数（resistance index:...
We here report a successful angioplasty for tibial artery occlusion using direct puncture and subsequent retrograde approach under surgical cutdown technique. An 82-year-old man with ulcer/gangrene in first second digits was referred to our hospital endovascular therapy (EVT) of lower extremity ischemia. Diagnostic angiogram revealed anterior (ATA) severe calcification. Subintimal attempted 0.014-inch hydrophilic guidewire but unsuccessful. A subsequently ATA recanalization. However, because...
This study aimed to evaluate the effect of ultrasound-assessed lesion morphology on outcomes drug-coated balloon (DCB) versus plain old angioplasty (POBA) treatment for de novo dysfunctional arteriovenous fistulas (AVF) lesions.
Arteriovenous fistula is recommended, but arteriovenous graft acceptable when a not possible. Acuseal an early cannulation with trilayer structure. Although primary patency rates of appear to be similar those other standard grafts, few studies have investigated long-term results and complications. In our series, delamination the wall structure occurred in 5.1% (6/115) by 21 months after implantation. The causes could divided into cannulation-related cannulation-unrelated. Here, we describe...
Insulation failure is a common cause of permanent pacemaker and implantable cardioverter-defibrillator lead failure.1–3 Most insulation failures occur inside the pocket, from connector to venous entry, often implying compression between clavicle first rib.4,5 Damage leads in this region are known be caused by soft tissue entrapment repetitive movements rather than true bone contact.6 Lead dysfunction mechanical contact with has also been reported, although rarely.
aims to demonstrate that a tunneled-cuffed catheter (TCC) implanted by nephrologist is safe, effective and associated with excellent results.METHODS: Retrospective study analyzed 149 consecutive performed temporaryto-tunneled-cuffed conversions in the operating room (OR) from dialysis facility March 2014 September 2017.The data collected consisted of total procedures performed, demographic characteristics population, success rates, aborted procedure, failure complications observed, survival...
超音波診断装置を用いたバスキュラーアクセス（vascular access:...
上腕動脈は上腕部を走行する動脈であり，肘関節部より1～2横指末梢側で橈骨動脈と尺骨動脈に分岐する．しかし，稀に腋窩付近またはその末梢側でそれらが分岐する高位分岐例が存在する．今回，超音波検査で高位分岐を正確に診断できた症例を中心に解説する．68歳，女性，右手第I‐IV指に潰瘍が出現し当院受診となった．超音波検査では腋窩付近で橈骨動脈が分岐する上腕動脈高位分岐例であった．上腕部の橈骨および尺骨動脈は血流を認めたが，前腕部の両者は閉塞していた．前腕部の骨間動脈においては微弱ながら血流シグナルを認めた．血管内治療を施行する方針となり，橈骨および尺骨動脈の分岐部をエコーガイド下でマーキングを行った．高位分岐のため，左鼠径部からアプローチしガイドワイヤーを進めた．造影画像とマーキング部から橈骨動脈起始部を同定し，橈骨動脈閉塞部を手関節部まで通過，バルーンカテーテルで拡張し血流を再開通させた．術前の超音波検査で橈骨動脈の起始部を同定したことが，血管内治療の手技において有用な情報になった．超音波検査において上腕動脈を描出する際は，必ず短軸像から描出し動脈が1本か2本かを意識する必要がる．また，...