First experience with DCB for treatment of dialysis access stenosis The Greek experience
|
|
|
- Gerard McCarthy
- 5 years ago
- Views:
Transcription
1 First experience with DCB for treatment of dialysis access stenosis The Greek experience D Karnabatidis Department of Interventional Radiology Patras University Hospital Patras, Greece
2 Background Vessel Restenosis Endovascular treatment options Restenosis Coronary angioplasty: ~ 9 months Carotid angioplasty: ~ 1 year Iliac angioplasty: ~ 5 years Femoral angioplasty: ~ 2 years AV-Fistula angioplasty: ~ 6 months AV-Graft angioplasty: < 6 months Aftab SA, et al. Randomized clinical trial of cutting Balloon angioplasty versus high-pressure balloon angioplasty in hemo- dialysis arteriovenous fistula stenosis resistant to conventional balloon angioplasty. J Vasc intervent Radiol 2014; 25:
3 Vascular Access Restenosis Mechanical and biochemical parameters contribute to a continuous neointimal hyperplasia formation Histological differences between veins and arteries Substantial differences in blood flow dynamics (stagnation and recirculation zones) ESRD causes marked endothelial dysfunction uremia oxidative stress inflammation Bessa, K.L, Ortiz, J.P. Journal of Visualization 2009 Diskin CJ, Blood Purification, 2010
4 2010 PCB PCB in DIAYSIS LEGS
5 Five-years Clinical Experience with Paclitaxel-coated Balloon Angioplasty for Stenoses Causing Dysfunction of Dialysis Arteriovenous Fistula and Synthetic Grafts
6 Purpose This audit was performed to evaluate the longterm safety and efficacy of paclitaxel-coated balloon (PCB) angioplasty of dysfunctional dialysis vascular access
7 Flowchart 70 patients 96 procedures 105 devices AVG 28 patients 31 procedures 32 devices AVG 25 patients 28 procedures 29 devices Corrupted data 8 patients 8 procedures 8 devices AVF 42 patients 65 procedures 73 devices AVF 37 patients 60 procedures 68 devices In Total 62 patients 88 procedures 97 devices
8 General Characteristics May 2010 August 2014
9 Outcome Measures Primary Target Lesion Primary Patency (TLPP) (Re-intervention-free) Secondary Identification of factors influencing TLPP Complications rates
10 Baseline Variables Mean Age ( years) 60 ±14 Gender (men/total) 40/ % Cause of ESRD (#/total) DM 19/ % GN 5/62 8% Unknown 26/ % PCKD 4/62 6.5% Other 8/ % Comorbidities (#/total) DM 29/ % HPT 23/ % Smoking 22/ % PAD 29/ % Heart disease 26/ % Stroke 8/ %
11 Procedural Baseline Variables I Native arteriovenous fistula % Radio-cephalic % Brachio-cephalic 20 54% Brachio-basilic (transposed) % Prosthetic arteriovenous graft % Brachial % Antebrachial 0 0% Straight 24 96% Loop 1 4%
12 Procedural Baseline Variables II Mean Circuit Age (years) 3.2 ±2,80 De novo lesions 38/ % Re-Interventions 50/ % Thrombosis* 8/ % *PCB following pertcuaneous declotting procedure
13 Devices Devices (#/total) INPACT 79/97 81,5% LUTONIX 16/ % EUROCOR 2/97 2% Size Diameter (mm) 5.8±1.1 Length (mm) 67±24 Post Dilation Devices* Diameter (mm) 7±2 Length (mm) 66±24 *Dorado, Atlas, Conquest, XXXL Vascular, Armada, Passeo, Mustang, Rival
14 Results
15 Results AVGs 23 venous juxta-anastomotic lesions (3/23 in stent graft restenosis) 5 axillary vein outflow lesions Mean AVG age: 3.0 ± 1.5 y Average PCB diameter: 6.5 ± 1.0 mm (length 57.8 ± 17.5 mm) Post-dilation: 32.1% (9/28 cases) Average diameter of post-dilation high pressure balloon catheters: 8.0 ± 2.0 mm (length 68 ± 33 mm). Clinical success and anatomic success: 100%
16 Results AVFs Main body lesions: 30 (50%) Juxta-anastomotic lesions: 24 (40%) Cephalic arch lesions: 2 (3.3%) Subclavian vein outflow lesions: 2 (3.3%). Average PCB diameter 5.6 ± 1.2 mm (length 71 ±7.1mm) Post-dilation: 28.3% (17/60 lesions ) Clinical success: 100% Anatomic success: 98.4% (one rupture at the cephalic arch with a 7 mm PCB not responding to prolonged inflation 8mm stent graft
17 6 months: 1 year: 2 years: 5.9%
18 AVF vs. AVG AVG 0.64 years vs years AVF HR 1.12, 95% CI: 0.66 to 1.89; p=0.65
19 Independent Predictors of TLPP* De novo Lesions Vascular Access Age <3 years Previous Thrombosis Stroke *By Multivariate Cox Regression Analysis
20 De novo HR: 2.54; 95%CI: , p=0.002
21 < 3 years HR: 0.38; 95%CI: , p=0.002
22 Thrombosis HR: 2.67; 95%CI: , p=0.01
23 Stroke HR: 3.11; 95%CI: , p=0.001
24 Complications Major: 1.1%: One cephalic vein rupture managed intraprocedurally with stent graft deployment Minor: 11.3% Small hematomas not requiring further treatment and not compromising dialysis
25 Conclusions In this real-life series, Paclitaxel-coated balloon angioplasty of dysfunctional dialysis access was safe and provided very satisfactory primary patency rates Treatment of de novo lesions was correlated with significantly better patency
26 Initial data are promising Growing experience Journal of Vascular and Interventional Radiology 2015
27 Ongoing large multicenter trials
28 Patras University Hospital
29 First experience with DCB for treatment of dialysis access stenosis The Greek experience D Karnabatidis Department of Interventional Radiology Patras University Hospital Patras, Greece
Konstantinos Katsanos, MSc, MD, PhD, EBIR
Konstantinos Katsanos, MSc, MD, PhD, EBIR Interventional Radiologist Patras University Hospital, Rion, Greece & Guy s and St. Thomas Hospitals, London, UK Honoraria from MEDTRONIC, BOSTON SCI Research
Lutonix in AV fistula and Early look AV IDE trial data
Lutonix in AV fistula and Early look AV IDE trial data Jackie P Ho Dept of Cardiac, Thoracic & Vascular Surgery National University of Singapore NUHS, Singapore Lutonix in AV fistula and final AV IDE trial
LUTONIX AV Clinical Trial
LUTONIX AV Clinical Trial A Prospective, Global, Multicenter, Randomized, Controlled Study Comparing LUTONIX 035 AV Drug Coated Balloon PTA Catheter vs. Standard Balloon PTA Catheter for the Treatment
Recurrent lesions in AV access & Initial DCB experience in India
Recurrent lesions in AV access & Initial DCB experience in India Dr. Virender K Sheorain Consultant Interventional Radiologist Medanta-The Medicity Hospital Gurgaon, INDIA Disclosure Speaker name:... I
Lutonix AV Clinical Trial
Long Term Effects of LUTONIX 035 DCB Catheter Interim 24 Month Results Scott O. Trerotola, MD, for the Lutonix AV Investigators Stanley Baum Professor of Radiology Professor of Radiology in Surgery Associate
Lutonix AV Clinical Trial
Long Term Effects of LUTONIX 035 DCB Catheter Interim 24 Month Results Ta-Wei Su MD Vascular surgery CGMH Taiwan Disclosure I have the following potential conflicts of interest to report: Consulting Employment
The Role of LUTONIX 035 DCB in AV Fistula Dysfunction Management in our Practice
The Role of LUTONIX 035 DCB in AV Fistula Dysfunction Management in our Practice Dr Kate Steiner Consultant Interventional Radiologist East and North Hertfordshire NHS Trust Disclosure Speaker name: Dr
Interventions for AV-Shunt stenosis: What works best PTA, Stent or DCB?
Interventions for AV-Shunt stenosis: What works best PTA, Stent or DCB? Martin Forlee Vascular Surgeon Cape Town Disclosure Speaker name: Martin Forlee I have the following potential conflicts of interest
Technical Aspects for Treating AV Dialysis Fistulae with the IN.PACT DCB. Andrew Holden Auckland Hospital Auckland, New Zealand
Technical Aspects for Treating AV Dialysis Fistulae with the IN.PACT DCB Andrew Holden Auckland Hospital Auckland, New Zealand LINC 2017 26 th January 2017 Disclosure Speaker name: Andrew Holden I have
Current Status of DCB Experience with Non- Femoropopliteal Applications (Dialysis, Tibial, Venous)
Current Status of DCB Experience with Non- Femoropopliteal Applications (Dialysis, Tibial, Venous) Saher Sabri, MD University of Virginia Health System Charlottesville, Virginia Dialysis vascular access
Prospective, randomized controlled study of paclitaxel-coated versus plain balloon angioplasty for the treatment of failing dialysis access
Prospective, randomized controlled study of paclitaxel-coated versus plain balloon angioplasty for the treatment of failing dialysis access Disclosure Speaker name:... I have the following potential conflicts
Introduction to the Native Arteriovenous Fistula: A primer for medical students and radiology residents
Introduction to the Native Arteriovenous Fistula: A primer for medical students and radiology residents Jesus Contreras, D.O. PGY-4 John Yasmer, D.O. Department of Radiology No Disclosures Objectives Introduce
Disclosures. Consultant/Independent Contractor: B Braun, Teleflex, MedComp, Cook, Bard, WL Gore Royalty: Cook, Teleflex
Disclosures Consultant/Independent Contractor: B Braun, Teleflex, MedComp, Cook, Bard, WL Gore Royalty: Cook, Teleflex DCB in Hemodialysis Access Scott Trerotola, MD 2016: 50 th birthday of the AVF History
Role of Covered Stents and Drug Eluting Balloons In Dialysis Access
Role of Covered Stents and Drug Eluting Balloons In Dialysis Access Joseph Habib, MD, FACS Assistant Professor Department of Surgery Division of Vascular and Endovascular Surgery University of Florida
COVERA covered stent to treat stenosis in arteriovenous fistula: 6-month results from the prospective, multi-center, randomized AVeNEW study
COVERA covered stent to treat stenosis in arteriovenous fistula: 6-month results from the prospective, multi-center, randomized AVeNEW study Panagiotis Kitrou MD, MSc, PhD, EBIR Consultant Interventional
AVF Prevalence. Local elastase to aid fistula maturation. I have nothing to disclose
Local elastase to aid fistula maturation Warren Gasper MD UCSF Vascular Surgery Fellow 2013 UCSF Vascular Symposium I have nothing to disclose AVF Prevalence 60.6% (April 2012) Fistula First Initiative
Qizhuang Jin. Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
Safety and Efficacy of the Paclitaxel Releasing Peripheral Balloon Dilatation Catheter (APERTO OTW ) for Arteriovenous Fistulae Stenosis: a Prospective, Multicenter, Randomized Controlled Trial APERTO
Jimmy Wei Hwa Tan, Surg, MD
Jimmy Wei Hwa Tan, Surg, MD Director, Department of Surgery Chief, Department of Cardiovascular Surgery Tainan An-Nan Municipal Hospital, China Medical University, Taiwan Disclosure I have the following
IN ARTERIOVENOUS FISTULA FAILURE
DRUG ELUTING BALLOON ANGIOPLASTY IN ARTERIOVENOUS FISTULA FAILURE Nicola Troisi, MD GUIDELINES GUIDELINES VAS 2007 GUIDELINES VAS 2007 GUIDELINES VAS 2007 GUIDELINES VAS 2007 2007!!!!!!!!!! GUIDELINES
Lutonix AV Clinical Trial
Lutonix AV Clinical Trial Long Term Effects of LUTONIX 035 DCB Catheter 18 month Interim Results Scott O. Trerotola, MD Stanley Baum Professor of Radiology Professor of Surgery Associate Chair and Chief,
IN.PACT AV Access IDE Study Full Baseline Data. Robert Lookstein, MD MHCDL New York, NY On Behalf of the IN.PACT AV ACCESS Investigators
IN.PACT AV Access IDE Study Full Baseline Data Robert Lookstein, MD MHCDL New York, NY On Behalf of the IN.PACT AV ACCESS Investigators Disclosures Speaker name: Robert Lookstein, MD... I have the following
COVERA Vascular Covered Stents in the Management of Dysfunctional AV Access
COVERA Vascular Covered Stents in the Management of Dysfunctional AV Access Bart L. Dolmatch, M.D., FSIR Palo Alto Medical Foundation Mountain View, CA USA This presentation is being made on behalf of
ASDIN 9th Annual Scientific Meeting
Stent Graft Placement is Best for Cephalic Arch and Central Vein Stenosis Dheeraj K. Rajan MD, FRCPC, FSIR Head - Division of Vascular and Interventional Radiology University of Toronto University Health
Bare Metal Stents vs Stent Grafts
Bare Metal Stents vs Stent Grafts ASDIN 12th Annual Scientific Meeting Phoenix, AZ, February 20, 2016 Dirk Hentschel, MD Director, Interventional Nephrology Brigham and Women s Hospital Disclosure Consultant:
Regardless of whether you are a vascular surgeon,
C A S E R E P O R T The Versatility of the GORE VIABAHN Endoprosthesis Several case reports highlighting its unique design and why it is a valuable tool for the interventionist. BY PETER WAYNE, MD Regardless
DCB in the treatment of av-accessa single center prospective study
DCB in the treatment of av-accessa single center prospective study Dr. med. Tobias Steinke Schön Klinik Fachzentrum Gefäßchirurgie, Düsseldorf Disclosure Speaker name: Dr. med. Tobias Steinke I have the
Juxta-anastomotic stenoses: angioplasty or surgery (or when/why should we wait)?
Juxta-anastomotic stenoses: angioplasty or surgery (or when/why should we wait)? Richard Shoenfeld MD, FSIR, FAHA The Access Center at West Orange West Orange, New Jersey USA SEDAV 2015 Madrid November
What s on the Horizon in Dialysis Access? Libby Watch, MD, FACS Miami Cardiac & Vascular Institute
What s on the Horizon in Dialysis Access? Libby Watch, MD, FACS Miami Cardiac & Vascular Institute Disclosures No relevant disclosures Employee Advanced Access Care Dialysis Work 5 operating surgeons 3
Real-World Experience With Drug-Coated Balloons in AV Access
GLOBAL ROUNDTABLE Real-World Experience With Drug-Coated Balloons in AV Access Experts discuss the current use of DCBs in AV fistulas and review how upcoming trials may influence progress in this space.
The Art of Angioplasty
The Art of Angioplasty Achieving and Defining Success Thomas M. Vesely, MD Saint Louis, Missouri Dr. Vesely is a consultant for: W.L. Gore & Associates Lutonix Imaging the Vascular Access Circuit A well
Why Can't I Cannulate This Fistula? Fistula Immaturity: The Simple But Critical Steps for a Functioning (Mature) AVF
Why Can t I Cannulate This Access? Steven J. Bander M.D. Adjunct Professor of Nephrology St. Louis University Director, Vascular Access Center, St. Luke s Hospital Saint Louis, MO Why Can't I Cannulate
LUTONIX DCB in AV Access: A Single Center Experience
LUTONIX DCB in AV Access: A Single Center Experience Dr Kate Steiner Consultant Interventional Radiologist East and North Hertfordshire NHS Trust Disclosure Speaker name:... I have the following potential
The SplitWire Percutaneous Transluminal Angioplasty Scoring Device. Instructions for Use
The SplitWire Percutaneous Transluminal Angioplasty Scoring Device Instructions for Use Contents Contains one (1) SplitWire device. Sterile. Sterilized with ethylene oxide gas. Radiopaque. For single use
Update from Korea on the Lutonix SFA registry 12 month data
Update from Korea on the Lutonix SFA registry 12 month data Prospective, Multicenter, Post-Market Registy Assessing the Clinical Use and Safety of the Lutonix Drug Coated Balloon in Femoropopliteal Arteries
ENDOVASCULAR TREATMENT OF MALFUNCTIONING HAEMODIALYSIS GRAFTS/FISTULAS. Dr R Uberoi Interventional Radiologist John Radcliffe hospital Oxford.
ENDOVASCULAR TREATMENT OF MALFUNCTIONING HAEMODIALYSIS GRAFTS/FISTULAS Dr R Uberoi Interventional Radiologist John Radcliffe hospital Oxford. Stenosis Stenosis Native fistula/grafts. Radio-cephalic 55-75%
Proven Performance Through Innovative Design *
Proven Performance Through Innovative Design * Deliver Our Next Generation AV Covered Stent Results The COVERA Vascular Covered Stent builds upon proven technologies from the category leader in AV Access.
COVERA Vascular Covered Stents Innovation in AV Access
IL0118 Rev.0 1 COVERA Vascular Covered Stents Innovation in AV Access Dheeraj Rajan, MD, FRCPC, FSIR Head and Associate Professor, Division of Vascular & Interventional Radiology Department of Medical
HD Scanning: Velocities and Volume Flow
HD Scanning: Velocities and Volume Flow Non-Invasive Lab Symposium West Orange, NJ April 27, 2018 Volume Flow Cindy Sturt, MD, FACS, RVT 500,000 Americans on dialysis 20-25% annual mortality 65% 5 year
All arteriovenous access circuits, whether native vein
Summary of the Gore REVISE Clinical Study This nationwide study reports on the safety and effectiveness of the GORE VIHN Endoprosthesis for the treatment of stenoses and thrombotic occlusions involving
Angioplasty remains the most common method
When AVF Angioplasty Fails Defining procedural success and overcoming common problems. By Thomas M. Vesely, MD Angioplasty remains the most common method of treating obstructive vascular stenoses associated
DCB in my practice: How the evidence influences my strategy. Yang-Jin Park
DCB in my practice: How the evidence influences my strategy Yang-Jin Park Associate Professor Division of Vascular Surgery, Department of Surgery Samsung Medical Center Sungkyunkwan University School of
ASDIN 7th Annual Scientific Meeting DISCLOSURES TECHNICAL CONSIDERATIONS TECHNICAL CONSIDERATIONS UTILITY OF ULTRASOUND IN EVALUATING ACCESS
DISCLOSURES UTILITY OF ULTRASOUND IN EVALUATING ACCESS DYSFUNCTION None Vandana Dua Niyyar, MD Assistant Professor of Medicine, Division of Nephrology, Emory University UTILITY OF ULTRASOUND IN ACCESS
PREVENTION AND TREATMENT OF ANEURYSMS OF AUTOGENOUS DIALYSIS ACCESSES STEPHEN L. HILL, M.D.,F.A.C.S
PREVENTION AND TREATMENT OF ANEURYSMS OF AUTOGENOUS DIALYSIS ACCESSES STEPHEN L. HILL, M.D.,F.A.C.S THE INCREASE IN THE CONSTRUCTION OF AUTOGENOUS FISTULAE OVER THE PAST TEN YEARS HAS BROUGHT WITH IT 1.
Clinical Study Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis
International Vascular Medicine Volume 215, Article ID 97122, 7 pages http://dx.doi.org/1.1155/215/97122 Clinical Study Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis Brendon
Few occlusive problems in arteriovenous access
Treatment of VG Venous nastomotic Stenosis Clinical indicators and treatment techniques for this common cause of arteriovenous graft failure. y art L. Dolmatch, MD Few occlusive problems in arteriovenous
Percutaneous transluminal angioplasty in the treatment of stenosis of hemodialysis arteriovenous fistulae: our experience
Percutaneous transluminal angioplasty in the treatment of stenosis of hemodialysis arteriovenous fistulae: our experience Poster No.: C-3355 Congress: ECR 2010 Type: Scientific Exhibit Topic: Interventional
KDOQI Guidelines. Overview. Predicting Successful Fistula Maturation Warren Gasper MD UCSF Vascular Surgery Fellow 2011 UCSF Vascular Symposium
DISCLOSURES: NONE Predicting Successful Fistula Maturation Warren Gasper MD UCSF Vascular Surgery Fellow 2011 UCSF Vascular Symposium KDOQI Guidelines AV fistulas have better outcomes than grafts or catheters
AV ACESS COMPLICATIONS. Ass. Prof. Dr. Habas
AV ACESS COMPLICATIONS Ass. Prof. Dr. Habas COMPLICATION AVF IS CONSIDERED A MINOR PROCEDURE INCIDENCE OF COMPLICATION- 20-27% MANY A COMPLICATION LEADS TO FAILURE OF FISTULA LOSS OF SITE AND VEIN FOR
Case #1. Case #1- Possible codes. Unraveling the -59 modifier. Principles of Interventional. CASE 1: Simple angioplasty
Unraveling the -59 modifier Principles of Interventional Coding Donald Schon, MD, FACP Debra Lawson, CPC, PCS Distinct or independent from other services performed on the same day Normally not reported
LUTONIX DCB in BTK Update on the BTK clinical program & single center experience
LUTONIX DCB in BTK Update on the BTK clinical program & single center experience Prof. Dr. med. Dierk Scheinert Department of Interventional Angiology University Hospital Leipzig Disclaimer 1. The information
Surgical Options in Thrombectomy for Non-Surgeons
Surgical Options in Thrombectomy for Non-Surgeons Shouwen Wang, MD, PhD, FASDIN AKDHC Ambulatory Surgery Center Arizona Kidney Disease and Hypertension Center Phoenix, Arizona Disclosure No relevant financial
Managing the Failing Dialysis Permacath: Results from a 5-year Retrospective Analysis
Interventional Original Article Managing the Failing Dialysis Permacath: Results from a 5-year Retrospective Analysis Panagiotis M. Kitrou 1, Panagiotis Papadimatos 1, Konstantinos Katsanos 1, Stavros
Cephalic Arch Stenosis: A unique entity
Cephalic Arch Stenosis: A unique entity Arif Asif, M.D. Professor of Medicine Director, Interventional Nephrology University of Miami, Miami, FL PUMP Kian K, Asif A: Semin Dial 2008 Prevalence of CAS 39%
Supera for the Juxta-anastomotic AVF Stenosis
Supera for the Juxta-anastomotic AVF Stenosis Dr Shannon D. Thomas Vascular Access Surgeon Conjoint Senior Lecturer University of New South Wales Sydney, Australia Disclosure Speaker name: Dr S. D. Thomas...
DURABLE. CONSISTENT. SAFE. IN.PACT Admiral Drug-Coated Balloon
DURABLE. CONSISTENT. SAFE. Drug-Coated Balloon THE SCIENCE BEHIND THE OUTCOMES DCB has proven, long-term durable outcomes across multiple clinical trials, as well as across complex patient and lesion types.
CATHETER REDUCTION. Angelo N. Makris, M.D. Medical Director Chicago Access Care
CATHETER REDUCTION Angelo N. Makris, M.D. Medical Director Chicago Access Care Objectives Discuss tools/techniques proven to improve AVF rates & decrease catheter rates Implement a change process in your
IVUS Guided Case Review Case Performed by Frank R. Arko III, MD Charlotte, NC
IVUS Guided Case Review Case Performed by Frank R. Arko III, MD Charlotte, NC The opinions and clinical experiences presented herein are for informational purposes only. Dr. Arko is a paid consultant for
Mechanical thrombectomy in acute thrombosis of dialysis fistulas: a multi-center study
Mechanical thrombectomy in acute thrombosis of dialysis fistulas: a multi-center study Clément Marcelin 1 Y Le Bras 1, MD, F. Petitpierre 1, MD, N. Grenier 1, MD PHD, J V D Berg MD PHD 3, B Huasen 2, MD
2006 NKF-DOQI Guidelines Preferred Vascular Access Order 1. Radiocephalic (wrist) fistula 2. Brachiocephalic (elbow) fistula 3. Basilic vein transposi
Stage 5 Chronic Kidney Disease Assessing the Results of AV Access: Realistic Outcomes in 2009 Sean P. Roddy, MD Albany, NY Defined as a GFR
4/29/2012. Management of Central Vein Stenoses. Central Venous Stenoses and Occlusions
Central Venous Stenoses and Occlusions Management of Central Vein Stenoses Robert K. Kerlan Jr. M.D. Professor of Clinical Radiology and Surgery University of California San Francisco Key Questions What
Tale of Neglected Aneurysm
Disclosures Tale of Neglected Aneurysm Consultant to FFCL Tushar Vachharajani, MD, FASN Chief, Nephrology Section Salisbury VAMC, NC Objectives How do you define Aneurysm? When and How do you treat? Defining
Access Preservation: Recurrent Central Venous Stenosis, Pacemaker Wires and other Nightmares. Who am I? Disclosures
Access Preservation: Recurrent Central Venous Stenosis, Pacemaker Wires and other Nightmares Jason Burgess, MD RVT Surgical Specialists of Charlotte CMC-Mercy Charlotte, NC Disclosures Gore Vascular- Consultant
AV Access Technology and Innovation DEVICES CHANGING HOW WE THINK ABOUT VASCULAR ACCESS
AV Access Technology and Innovation DEVICES CHANGING HOW WE THINK ABOUT VASCULAR ACCESS Vascular Access New Technology What problem are you trying to solve for? Most common problem is inadequate outflow
Sample page. POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years. Visit optum360coding.com.
2018 Complete Guide for Interventional Radiology An in-depth guide to interventional radiology coding, billing, and reimbursement for facilities and physicians POWER UP YOUR CODING with Optum360, your
*PTA Failure: Recoil >30% stenosis or more than 2 PTA s within 3 mo. Bart Dolmatch, MD
The views presented reflect those of the author/presenter and do not necessarily reflect those of ASDIN nor serve as an endorsement of safety, efficacy or applicability of said procedure. the Endovascular
Why and how to prep the vessel
Why and how to prep the vessel Drug elution in the SFA: Leave the right thing behind. Debating evidence to provide an answer Erwin Blessing, MD, FESC SRH Klinikum Karlsbad-Langensteinbach Germany Disclosure
Postoperative AV Fistula Evaluation. Postoperative examination protocol. Postoperative AVF Protocol. Hemodialysis Access Surveillance
Hemodialysis Access Surveillance Postoperative AV Fistula Evaluation Failure of maturation Stenosis Perigraft mass/fluid collection Joseph L. Mills, Sr., M.D. Professor of Surgery Chief, Division of Vascular
Stellarex Drug-coated 0.035" Angioplasty Balloon. Featuring EnduraCoat Technology. The Clear DCB Choice
Stellarex Drug-coated 0.035" Angioplasty Balloon Featuring EnduraCoat Technology The Clear DCB Choice Top-tier outcomes with the lowest therapeutic drug dose in all patients common to complex 89.0 % patency
The HeRO Graft. Shawn M. Gage, PA Division of Vascular Surgery Duke University Medical Center
The HeRO Graft Shawn M. Gage, PA Division of Vascular Surgery Duke University Medical Center Faculty Disclosure I disclose the following financial relationships: CryoLife/Hemosphere, Inc. & W.L. Gore and
Lysis-Assisted Balloon (LAB) Thrombectomy
Lysis-Assisted Balloon (LAB) Thrombectomy Panagiotis M. Kitrou MD, MSc, PhD, EBIR Consultant Interventional Radiologist Interventional Radiology Dpt. Patras University Hospital Greece Facts & Figures Thrombosis:
Selection of Permanent Hemodialysis Vascular Access
Selection of Permanent Hemodialysis Vascular Access TABLE OF CONTENTS 1.0 Scope...1 2.0 Recommendations & Rationale... 2 3.0 References... 3 4.0 Sponsors... 9 5.0 Effective Date... 10 Appendix 1: Key Elements
Hemodialysis Fistula Maturation Consortium
Hemodialysis Fistula Maturation Consortium Rationale for Fistula Maturation Study Dialysis Access Consortium AVF study 60% of new AVFs were unusable for dialysis at 4-5 months post surgery No predictors
Sid Bhende MD Sentara Vascular Specialists April 28 th Dialysis Access Review: Understanding the Access Options our Patients Face
Sid Bhende MD Sentara Vascular Specialists April 28 th 2018 Dialysis Access Review: Understanding the Access Options our Patients Face Disclosures Dialysis Background Why is it important? Outline National
Drug eluting stents and balloons in peripheral arterial disease A.T.O. ABDOOL-CARRIM UNIVERSITY OF WITWATERSRAND
Drug eluting stents and balloons in peripheral arterial disease A.T.O. ABDOOL-CARRIM UNIVERSITY OF WITWATERSRAND Drug eluting stents and balloons Endovascular treatment now becoming more popular for treatment
Current Non-Surgical Cardiac Interventions. By Pam Bayles, RN, BSN
Current Non-Surgical Cardiac Interventions By Pam Bayles, RN, BSN Balloon Angioplasty & DES A balloon-tipped catheter was first used in 1964 to treat a cause of atherosclerotic disease in a patient s leg
Outcomes Of Combined Rheolytic And Rotational Mechanical Thrombectomy For Total Access Circuit Thrombosis In Hemodialysis Patients
Outcomes Of Combined Rheolytic And Rotational Mechanical Thrombectomy For Total Access Circuit Thrombosis In Hemodialysis Patients Nicholas Petruzzi, MD Raphael Cohen, MD Mark Mantell, MD Timothy W. Clark,
Subclavian artery Stenting
Subclavian artery Stenting Etiology Atherosclerosis Takayasu s arteritis Fibromuscular dysplasia Giant Cell Arteritis Radiation-induced Vascular Injury Thoracic Outlet Syndrome Neurofibromatosis Incidence
Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)
Dialysis Vascular Access Coverage, Coding and Reimbursement Overview Hospital Outpatient 2019 Edition All Reimbursement Amounts are Listed at ational Unadjusted Medicare Rates and Do ot Include the 2%
UPDATE IN VASCULAR ACCESS Mercedeh Kiaii MD FRCPC Rick Luscombe RN BSN CNeph(C) Elizabeth Lee MD FRCPC
UPDATE IN VASCULAR ACCESS Mercedeh Kiaii MD FRCPC Rick Luscombe RN BSN CNeph(C) Elizabeth Lee MD FRCPC Background Endovascular AVF Outline Data from FLEX and NEAT study SPH data Clinical experience Cannulation
MICHAEL R. JAFF, DO MASSACHUSETTS, UNITED STATES. Medtronic Further. Together
DRUG-COATED BALL0ON TREATMENT FOR PATIENTS WITH INTERMITTENT CLAUDICATION: INSIGHTS FROM THE IN.PACT GLOBAL FULL CLINICAL COHORT MICHAEL R. JAFF, DO MASSACHUSETTS, UNITED STATES Medtronic Further. Together
ESVB State of the art: DES, DCB and the role of debulking. Gunnar Tepe, Rosenheim
ESVB 2013 State of the art: DES, DCB and the role of debulking Gunnar Tepe, Rosenheim DES I Sirocco Sirolimus coating, quick release Duda et al., J Vasc Surg 2002; 106: 1505-1509 20 DES II Strides Everolimus
Department of Surgery, Vascular and Endovascular Surgery Unit San Giovanni di Dio Hospital, Florence, Tuscany, Italy
IL TRATTAMENTO ENDOVASCOLARE CON PALLONI MEDICATI RIDUCE IL RISCHIO DI NUOVA RESTENOSI IN PAZIENTI DIALIZZATI CON STENOSI RECIDIVE DELL ACCESSO VASCOLARE Pierfrancesco Frosini Direttore Chirurgia Vascolare
Coding of Procedures in Interventional Nephrology Produced in collaboration with:
Coding of Procedures in Interventional Nephrology 2013 Produced in collaboration with: Introduction Proper coding of interventional procedures is a difficult and daunting, but essential task. Each procedure
Dr. Murty Mantha MD FRACP Cairns Base Hospital Cairns. DNT 2011 Hunter Valley
Dr. Murty Mantha MD FRACP Cairns Base Hospital Cairns DNT 2011 Hunter Valley Approximately 45% of AVF are functional without intervention after creation The procedure rate is 1.45-3.3 procedures/avf
Peripheral Vascular Disease
Peripheral artery disease (PAD) results from the buildup of plaque (atherosclerosis) in the arteries of the legs. For people with PAD, symptoms may be mild, requiring no treatment except modification of
Final Results of the Feasibility Study for the Drug-coated Chocolate Touch PTA balloon. (The ENDURE Trial)
Final results of the feasibility study for the drug-coated Chocolate Touch PTA balloon of of femoropopliteal Femoropopliteal lesions lesions: (The ENDURE Trial) Final Results of the Feasibility Study for
Vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries 19(34):
19 34 2015 08 20 Chinese Journal of Tissue Engineering Research August 20, 2015 Vol.19, No.34 ( 430000) 38 30 8 17 61 12 100% 12 92%(35/38) 1974 430000 :R318 :B :2095-4344 (2015)34-05496-05 2015-06-09
Klinikum Rosenheim Department of Diagnostic and Interventional Radiology
Klinikum Rosenheim Department of Diagnostic and Interventional Radiology Is Directional Atherectomy (Silverhawk Or Turbohawk) With DEB, Better Than DEB Alone: Based On The DEFINITIVE AR RCT: 1-Year Results
Drug Eluting Balloon for AVF Angioplasty : Does it work?
Drug Eluting Balloon for AVF Angioplasty : Does it work? Dr Kiang Hiong TAY (MBBS, FRCR, FAMS, FSIR) Head & Senior Consultant, Dept of Diagnostic Radiology, Singapore General Hospital Director Interventional
Angiographic dissection pattern and patency outcomes of post balloon angioplasty for SFA lesions -a retrospective multi center analysis-
Angiographic dissection pattern and patency outcomes of post balloon angioplasty for SFA lesions -a retrospective multi center analysis- Masahiko Fujihara Kishiwada Tokushukai Hospital, Osaka, Japan Disclosure
Salvaging prosthetic dialysis fistulas with stents: Forearm versus upper arm grafts
From the Society for Clinical Vascular Surgery Salvaging prosthetic dialysis fistulas with stents: Forearm versus upper arm grafts Stephen Kolakowski, Jr, MD, Matthew J. Dougherty, MD, and Keith D. Calligaro,
CIRCUIT OPTIMIZING THE VASCULAR ACCESS. Bringing long-term value to AV access creation and intervention. Sponsored by Gore & Associates.
Supplement to June 2018 OPTIMIZING THE VASCULAR ACCESS CIRCUIT Bringing long-term value to AV access creation and intervention TABLE OF 2 SUPPLEMENT TO ENDOVASCULAR TODAY JUNE 2018 VOL. 17, NO. 6 CONTENTS
Maximizing Outcomes in a complex population with Drug-coated balloon
Maximizing Outcomes in a complex population with Drug-coated balloon March 13, 2018 Chumpol Wongwanit, MD Siriraj Hospital, Mahidol University, Bangkok, Thailand LINC Asia-Pacific 2018, Hong Kong Disclosure
Intervention for Lower Extremity PAD: When, why and what?! Robert F Cuff, MD FACS RVT RPVI
Intervention for Lower Extremity PAD: When, why and what?! Robert F Cuff, MD FACS RVT RPVI 1 Disclosures I have no financial disclosures related to this talk Objectives 1. Discuss indications for intervention
Dialysis circuit procedures: arteriovenous (AV) fistula repair
Coding and Medicare national payment guide 2018 Dialysis circuit procedures: arteriovenous (AV) fistula repair All coding, coverage, billing and payment information provided herein by Philips is gathered
Medical Director/Surgeon as Partners WebEx February 11, 2010
Medical Director/Surgeon as Partners WebEx February 11, 2010 Over 400,000 patients are treated yearly for ESRD in the USA; 60% of these patients receive some form of hemodialysis Despite major advances
UC SF. End Stage Renal Disease. National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI) BUT-- No Cephalic Vein What s Next
No Cephalic Vein What s Next End Stage Renal Disease Charles Eichler MD Clinical Professor of Surgery Division of Vascular Surgery UCSF April 5, 2014 Population of patients with ESRD growing rapidly -
Ultrasound as a Tool for Preoperative Planning, Monitoring, and Interventions in Dialysis Arteriovenous Access
Vascular and Interventional Radiology Review Shenoy and Darcy Ultrasound in Dialysis Interventions Vascular and Interventional Radiology Review FOUS ON: Surendra Shenoy 1 Michael Darcy 2 Shenoy S, Darcy
12-month Outcomes of Post Dilatation in the IN.PACT Global CTO Cohort. Gunnar Tepe, MD RodMed Clinic Rosenheim Rosenheim, Germany
12-month Outcomes of Post Dilatation in the IN.PACT Global CTO Cohort Gunnar Tepe, MD RodMed Clinic Rosenheim Rosenheim, Germany Disclosure Speaker name: Gunnar Tepe I have the following potential conflicts
Since the initiation of hemodialysis, multiple inventions
Special Feature Stent Graft for Nephrologists: Concerns and Consensus Loay Salman and Arif Asif Division of Nephrology, Section of Interventional Nephrology, University of Miami Miller School of Medicine,