16 results found in Vascular Access
Early Experience of the Wrapsody Cell-Impermeable Stent in Maintaining Arteriovenous Access in Patients on Haemodialysis
By: Edmund Charles
Introduction Arteriovenous fistula (AVF) stenoses can lead to poorer quality haemodialysis (HD) and precede AVF occlusion and failure, with most patients undergoing repeated balloon angioplasty (POBA) to maintain access patency. A novel, cell-impermeable stent has been associated with improved access patency compared with POBA. We report our centre’s early experience using this stent in patients with AVF stenoses requiring intervention. Methods A case series of patients >18 years with a mature AVF for HD who had AVFs with clinical and/or radiographic evidence of outflow obstruction or AVF dysfunction. The primary outcome was successful HD, target lesion primary and primary-assisted patency. Secondary outcomes included procedural complications, overall need for reintervention, and AVF flowrate and venous pressure (VP) at HD. Results 9 consecutive patients (7 female), mean age 58, had a total of 14 stents inserted between November 2024-October 2025. Mean follow-up was 4.3±3.6 months. 100% of patients underwent successful HD after intervention; primary patency and primary-assisted patency was 80% and 100%, respectively. There were no procedural complications and two reinterventions during follow-up, both for non-instent or edge stenoses; the cohort had undergone a total of 29 venoplasties in the preceding 3 years for their stenoses. The mean change in AVF flowrate and VP after intervention was 589.7±368.1 ml/min (95% CI= 262.2-743.1, p=0.004) and -62.22±31.8 mmHg (95% CI=-81.4- -43.0, p<0.001), respectively. There were no significant differences between first post-procedure flowrates and VPs and the latest acquired flowrates and VPs, suggesting sustained improvements after intervention. Conclusion We found the use of a cell-impermeable stent is an effective intervention for improving and maintaining AVF access patency in patients requiring HD. It is associated with at least equal early clinical outcomes compared with POBA and appears to reduce the need for repeated interventions.
Vascular AccessHealth Related Quality of Life (HRQoL) Outcomes in Maintenance Haemodialysis Patients: Experience from Northern Srilanka
By: Vinojan Satchithanantham
Aims Chronic kidney disease (CKD) is a chronic condition that progressively worsens with time and has significant impact on their Health-related Quality of Life (HRQoL). CKD of unknown origin is endemic in Northern part of Srilanka. Meeting the haemodialysis needs of all patients is particularly difficult in settings with limited healthcare resources and infrastructure. This study investigates the HRQoL in individuals undergoing maintenance haemodialysis in resource limiting set up. Methodology A cross-sectional descriptive study was conducted among 430 patients undergoing state sector haemodialysis centres across Northern Province, Sri Lanka. They were recruited using stratified sampling method. The validated questionnaire Kidney Disease Quality of Life Short Form (KDQOLSFTM1.3) used to assess the Quality of Life. Ethical approval was obtained from Institutional Review Board. Results The mean age of the participants was 53.31 years (SD=13) and 79.5% were males. Among 430 participants 24.9% (n- 107) undergo haemodialysis via central access and remains via Arteriovenous fistulas (AVFs). Hypertension (79.8%) and diabetes (37.4%) were the most common comorbidities, and 75.1% had arteriovenous fistula access, mainly brachiocephalic type. The leading cause of renal failure was Unknown aetiology 53.3% followed by hypertension (17.9%) and diabetes (15.8%). Mean Score (SD) for physical component summary, mental component summary and kidney disease component summary were 29.92 (15.47), 45.05 (20.05) and 56.03 (10.12) respectively. (Figure 1) The highest mean (SD) score was for dialysis staff encouragement 93.43 (12.73) followed by patient satisfaction 77.34 (17.0), and social support 71.27 (26.79). Role limitation physical 4.3 (15.80), work status 11.16 (24.69), burden of kidney disease 19.16 (18.68) had the lowest scores. (Table 1) Conclusions Patients in low middle-income country demonstrated comparatively lower HRQoL emphasising the importance of continued research and appropriate interventions to optimise patient centred outcomes in resource constrained healthcare systems.
Vascular Access4 year real world outcomes of fistula outflow stenoses treated with novel cell impermeable endoprosthesis
By: Basil Zia Khan
Our retrospective study investigated real world outcomes of fistula outflow stenoses treated with novel cell impermeable endoprosthesis. Patients from the first in man cases of Wrapsody stent (Merit Medical, South Jordan, UT, USA). deployment between 1/1/2019-31/12/2019 were included in this study. Data on severity of stenosis, de novo or recurrent lesion, date of stenting, date/number of interventions on target lesion during a 4 year follow up period were included. The end point of this study was either patient death, date of renal transplantation or fistula occlusion/abandonment. Primary patency (PP) and primary assisted patency rates were assessed up to 4 years following stent insertion. Primary patency was defined as time from stent insertion to first re intervention on target lesion. Our study included a total of 20 patients. Mean age was 68, 7 males and 13 females. Mean percentage and length of stenosis were 71% and 30 mm respectively. A total of 12 cephalic arch lesions, 4 arteriovenous graft anastomotic lesions and 4 native venous outflow segment lesions were treated with the Wrapsody stent. Our experience of the Wrapsody endoprosthesis for treatment of cephalic arch and AVG stenoses demonstrates a higher primary patency rate up to 48 months post insertion when compared with plain balloon angioplasty. Multiple studies demonstrate a primary patency rate ranging from 23-76% at 6 months and 9.5-45% at 12 months (1) for CAS treated with POBA. Primary patency rates for AVG stenoses treated with POBA have been reported to range from 12.3-23% at 6 months and 5.6%-25% at 12 months (2). Based on our experience there is strong argument for primary stenting of cephalic arch or arteriovenous graft anastomotic stenoses. References: 1. Pisano, U., Stevenson, K., Kasthuri, R. et al. Cephalic arch stenosis: an analysis of outcome by type of first intervention. CVIR Endovasc 7, 13 (2024). https://doi.org/10.1186/s42155-023-00424-4 2. Ratnam L, Karunanithy N, Mailli L, Diamantopoulos A, Morgan RA. Dialysis Access Maintenance: Plain Balloon Angioplasty. Cardiovasc Intervent Radiol. 2023 Sep;46(9):1136-1143. doi: 10.1007/s00270-023-03441-x. Epub 2023 May 8. PMID: 37156943; PMCID: PMC10471649.
Vascular AccessUltrasound-Guided Liposuction for Superficialization of AV Fistulas for Enhanced Needling: A Case Series
By: Shabin Fahad
Introduction and Aim: Deeply located arteriovenous fistula (AVF) vein is a common cause of cannulation failure among haemodialysis patients. Conventionally, surgical superficialization is done to address the issue but is invasive with high scar burden and bleeding complications. To mitigate this, we introduced liposuction as an alternative and less invasive way of superficialization. Since Feb 2025, we had performed this procedure in five patients and the outcomes are discussed. Methods: Six patients with End Stage Kidney Disease on haemodialysis and a deeply located AV fistula underwent liposuction for superficialization between February 2025 to October 2025. All of them were referred for cannulation failure due to vein depth. All liposuction procedures were under ultrasound guidance. Cases were performed under general anaesthesia, regional block with or without conscious sedation. Liposuction was done (using standard cannula) in the region overlying the venous outflow segment of the AVF to reduce the subcutaneous tissue thickness. The procedures were done jointly by a plastic surgeon and a vascular surgeon. A mixture of normal saline, lidocaine, and epinephrine (Tumescent solution) was infiltrated into the subcutaneous fat beforehand to aid fat removal, provide local anaesthesia, and minimize bleeding via vasoconstriction. Patients were reviewed at 4–6 weeks post-procedure for assessment of fistula usability and needling outcomes. Any complications or reinterventions were recorded. Results: All six patients underwent successful ultrasound-guided liposuction without intraoperative complications. The mean reduction in vein depth was from >1 cm pre-procedure to 3–6 mm post-procedure, enabling direct visualisation and successful cannulation in four patients. One patient has not yet initiated needling at the time of reporting. Brachial artery flow post-liposuction ranged between 1400–2000 ml/min, confirming maintained fistula patency. One patient developed symptomatic central venous stenosis unrelated to the liposuction site, which was successfully managed with venoplasty. There were no wound infections, haematomas, or fistula thromboses. Cosmetic outcomes were satisfactory in all cases. Conclusions: Ultrasound-guided liposuction offers a safe and effective minimally invasive option for superficializing deeply sited AVFs, avoiding open surgical revision. This technique facilitates successful needling and dialysis access maturation with minimal morbidity. Larger studies with longer follow-up are warranted to confirm durability and reproducibility of results
Vascular AccessNovel hybrid endovascular suture-free Arterio-Venous anastomosis technique for haemodialysis access construction: A Single-Center Case Series
By: Ilias Avgerinos
We describe a single centre case series of a novel hybrid endovascular suture free technique for vascular access in haemodialysis patients
Vascular AccessLong-term patency of arteriovenous fistulas as a vascular access in paediatric age group patients with end-stage renal disease.
By: Akram Ibrahim
Background: Vascular access (VA) for hemodialysis (HD) is the cornerstone of treatment of end-stage renal disease in children. Purpose: To evaluate the causes that may result in primary failures, to evaluate the long-term outcome of AVFs in the vascular access as regards primary and secondary access patency, and to study the effect of patients’ demographics and type of VA upon patency. Patients and methods: Paediatric age group patients with ESRD from El Shatby University Hospital for Children were evaluated by duplex ultrasound and VA was constructed. Results: 218 children were evaluated.188 children had AVF. The initial success rate was 96.8%. Early failure occurred in 13.9%. The mean follow-up was 18.9 ± 11.2 months. 75% of our patients were blow 50th percentile. The mean maturation-time was 1.7±0.5 months. Primary and secondary patency rates at 1, 2, and 3 years of follow-up, were 80.1% (± 2%), 67.3% (±2%), 41.3% (±2%), and 85.4% (±1%), 75.6% (± 1%), and 67.4% (± 1%) respectively. Complications were stenosis, thrombosis, infection, venous hypertension, steal, aneurysms and pseudoaneurysm, and high-flow AVF. At the end of the follow-up period, 32 (17.3%) AVFs were complicated and eventually failed, 20 (10.8%) were abandoned due to death or patients lost follow-up, and 125 (67%) were patent. Conclusion: AVFs in paediatric age group have a good outcome and long-term patency provided by good choice of the patient, and operation by dedicated surgeons. Surveillance of the fistula and rapid correction of any complications are very crucial steps to keep the fistula functioning.
Vascular AccessComparison of drug-coated balloon versus plain balloon angioplasty for autogenous hemodialysis access dysfunction: A prospective cohort study
By: Mohamed Ismail
Background: Both drug-coated balloon (DCB) angioplasty and conventional plain balloon angioplasty can be implemented to treat hemodialysis dysfunction. The present study aims to compare the safety and efficacy of these two approaches by conducting a prospective cohort study. Objective: The study aims to evaluate DCB safety and arteriovenous fistula effectiveness in relation to plain balloon for hemodialysis access dysfunction. Patients and Methods: All patients were allocated and blinded, randomized during the period of study into two groups. Group A: patients were operated on with drug-eluting balloons (n=40), while group B patients were operated on with standard balloons (n=40). The results of both groups were analyzed and compared. Results: DCB was used to treat 40 patients (mean age, 49.48±8 years) with failed arteriovenous fistulas. These patients were compared with a reference group of 40 patients, mean age 50.6±9.4 years, who had just simple balloon PTA. Regular PTA balloons were used to dilate every case of stenosis. In the research group, DCBs were used for medication delivery after hemodynamic success (30% residual stenosis). The 6-, 12-, and 24-month follow-up intervals were used. Comparisons were made between primary, primary assisted, and secondary patency. At 0.05, the statistical significance was established. When primary patency was evaluated between the two groups, it was shown that the study group (DCB) had substantially greater results at 12 months (75.0 vs. 52.5%; P=0.036) and 24 months (52.5 vs. 30.0%; P=0.041). At 24 months, there were notable variations in secondary patency (52.5 vs. 30.0; P=0.041). Conclusion: In addition to lowering the number of interventions and improving target lesion primary patency over the first 12 and 24 months, DCB also improves secondary patency at the 24-month mark.
Vascular AccessDifferent Modalities for Management of Thrombosed Arteriovenous Fistula: Multicenter Experience
By: Mohamed Ismail
Introduction: This study aims to report and evaluate different declotting modalities with their outcomes for salvage of thrombosed native dialysis access. Patients and methods: Between March 2023 to March 2024, 70 patients with first time thrombosed native arteriovenous fistula (AVF) were recruited, 27 radio-cephalic, 20 brachio-cephalic and 23 brachio-basilic AVFs were treated either surgically with thrombectomy or endovascularly using different endovascular declotting concepts. Patients had follow-up at 1 week, 1, 3 and 6 months postoperatively. Results: In our study 15.7% (n=11/70) were treated with open thrombectomy and 84.3% (59/70) were treated endovascularly using 5 different techniques. Techniques used were open surgical thrombectomy, balloon maceration, pulse spray thrombolysis, mechanical thrombectomy (Aspirex device), aspiration thrombectomy (Penumbra device) and rheolytic mechanical thrombectomy (Angiojet device). Clinical success achieved in each group was 72.7%, 70%, 69.2%, 100%, 100% and 90.9% respectively (p=0.175), with 6-month primary patency 72.7%, 60%, 69.2%, 75%, 77.8% and 86.4%, respectively (p=0.629). Conclusions: Surgical and endovascular intervention for thrombosed AVFs have comparable early clinical success and short-term primary and secondary patency rates.
Vascular AccessShuntMerlin: Artificial intelligence (AI) - Based Longitudinal Monitoring of Dialysis Shunts Using Smartphone-Generated Audio Data
By: Alexander Hyhlik-Duerr
Aims The ShuntMerlin project aims to develop an AI-based system for longitudinal monitoring of dialysis shunts using smartphone-generated audio data. The objective is to enable the early detection and prediction of shunt complications—such as stenosis and thrombosis—that are common among hemodialysis (HD) patients. By integrating patient-generated acoustic data with clinical ultrasound parameters, the project seeks to improve patient safety, reduce hospitalizations, and lower healthcare costs associated with vascular access failure. Methods ShuntMerlin is a joint initiative between the University Hospital Augsburg (UKA) and Carealytix Digital Health GmbH (CX). The project has received a state funding (“Bayern innovativ”) of one million Euros. CX is a certified medical technology company and a leader of software development and AI modeling. Over the project period (November 2025 – September 2027), several work packages will be implemented, including study protocol, ethical approval, development of a patient smartphone app, a clinician web portal, data collection from ≥50 HD patients and a iterative AI model development, respectively. After proper training, patients themselves will record weekly audio signals over their shunt using a standard smartphone. These data, together with ultrasound parameters collected during clinical follow-ups, will train a machine learning model capable of classifying current shunt function and predicting future complications. Results Expected study outcomes include: • A validated smartphone app for patient-led shunt monitoring and a web portal for clinician data review. • A robust AI model capable of identifying and predicting pathological changes in shunt function. • A dataset of longitudinal, real-world audio and ultrasound recordings—the first of its kind in dialysis research. On-going pre-studies (e.g., ShuntWizard) have confirmed that smartphone microphones can achieve audio quality comparable to electronic stethoscopes. The project anticipates that its approach will significantly improve early detection accuracy while reducing clinical workload. Ideally, we will be able to present the first preliminary results at Charing Cross 2026. Conclusions ShuntMerlin introduces an innovative, low-threshold telemonitoring approach that empowers HD patients to actively participate in their care. By combining AI with widely available smartphone technology, it offers a cost-efficient, scalable solution for detecting vascular access complications early. Ultimately, ShuntMerlin aims to establish a new standard for proactive, patient-centered vascular access monitoring, improving outcomes and quality of life for individuals living with chronic kidney disease.
Vascular AccessSaving the Access: Hybrid Fix to Central Vein Occlusion in a Young Hemodialysis Patient - Case Report
By: Kinagabran Sivananthan
Central vein occlusion (CVO) of the subclavian or innominate vein is a serious and often debilitating complication among long-term hemodialysis patients. When venous hypertension develops in the presence of a functioning ipsilateral arteriovenous fistula (AVF), clinicians face the dual challenge of symptom relief and preservation of dialysis access. Standard endovascular interventions, such as percutaneous transluminal angioplasty (PTA) and stenting, depend on successful guidewire passage across the occlusion, an outcome not always achievable. In these cases, surgical or hybrid approaches become essential. We present a case illustrating the effective use of a hybrid strategy in a young patient with limited vascular options and a functioning right Brachio-Basilic fistula (BBF).
Vascular AccessRetrospective Analysis of Scoring Balloon versus Plain Old Balloon Angioplasty in Endovascular Maintenance of Arterio-Venous Access
By: Xiao Wen Lim
Aims: Arteriovenous fistulas (AVFs) are the primary vascular accesses for hemodialysis in patients with chronic renal failure. This study examined the efficacy of scoring balloon (SB) angioplasty in maintaining patency of AVFs. Methods: Inclusion criteria compromised elective or emergency AVF fistuloplasty, non-maturation balloon-assisted fistuloplasty and AVF stenosis. Patients with concomitant central venoplasty or concomitant drug-coated balloon (if recurrence <6 months) were included. Exclusion criteria included arteriovenous grafts (AVGs), thrombosed AVF and isolated central venoplasty procedures. Baseline patient characteristics, AVF details, operation details and subsequent flow rates were retrospectively reviewed. Results: 48 patients (26 male, 22 female; mean age, 65.48±8.59 years) were retrospectively analysed. 14 of the patients received SB angioplasty, with the remaining 34 receiving traditional balloon angioplasty as control. Of these AVFs, 14 were radio-cephalic, 26 were brachio-cephalic and 8 were brachio-basalic AVFs. There were no statistically significant differences in preoperative variables of both groups. Technical success was achieved in 100.0% of index operations, with no statistically significant difference in the number of complications between the SB group and the control. The SB group achieved a significantly greater percentage increase in brachial artery volume flow than the control (145.0% vs 76.5%, p=0.05). Kaplan-Meier estimates showed that at 6 months, primary assisted patency was 40.4% for SB angioplasty and 57.1% for control (p=0.50), secondary patency was 100.0% for SB angioplasty and 97.1% for control (p=0.35). At 12 months, secondary patency was 100.0% for SB angioplasty and 80.9% for control angioplasty (p=0.35). Although these differences were statistically insignificant, there was a trend for secondary patency to be higher for SB. Conclusion: In this study, SB angioplasty demonstrates comparable results to traditional balloon angioplasty in terms of primary assisted patency and secondary patency of AVFs. While results are limited by the small sample size and retrospective design, the study suggests SB angioplasty is safe and non-inferior to conventional balloons, warranting further investigation on larger scales.
Vascular AccessComparison of Balloon-Expandable and Self-Expandable Stentgrafts in Vascular Access Outflow Stenosis Management
By: Alessandra Bandiera
Severe outflow vein stenosis is a leading cause of haemodialysis vascularaccess dysfunction. While self-expandable stent grafts are well established, the role of balloon-expandable stent grafts in this setting remains poorly defined. We conducted a retrospective, observational cohort study across two vascular access centres, comparing patients treated for severe outflow vein stenosis with either balloon-expandable (BE) or selfexpandable (SE) stent grafts. Thirty patients received BE stents between July 2018 and December 2020, and twenty-six received SE stents between January 2021 and December 2023. Follow-up included clinical assessment and Doppler ultrasound at regular intervals. Technical success was achieved in 96.4% of cases, with 100% immediate clinical success. The SE group showed superior primary patency at 6, 12, and 24 months (100%, 90%, and 75%) compared to the BE group (53.3%, 46.7%, and 26.7%) (p = 0.036). Functional patency at 24 months was 100% in the SE group versus 36% in the BE group (p = 0.013). Twenty-four of 25 reinterventions occurred in the BE group, and all eight cases of stent graft abandonment involved BE devices. While both devices were safe and technically effective, self-expandable stent grafts demonstrated superior long-term patency and durability, supporting their preferential use in managing venous outflow stenosis in haemodialysis access.
Vascular AccessNOVEL BRACHIO-CEPHALIC AVG CONSTRUCTION BY ENDOVASCULAR THERAPY OF AN IATROGENIC ARTERIOVENOUS FISTULA IN A FAILED BRACHIO-AXILLARY ACCESS GRAFT
By: Georgios Chatzantonis
Iatrogenic arteriovenous fistula (AVF) in hemodialysis access (HD) synthetic graft (AVG) may occur during cannulation by accidentally and inadvertently puncturing or piercing a vein adjacent to the graft, resulting in an abnormal communication between graft and vein. The ensuing outflow via the iatrogenic AVF may be felt as a palpable thrill diverting from the anatomic location of the graft, or a pulse deficit in the afflicted limb. High flow iatrogenic AVFs may generate competitive outflow within the AVG jeopardizing its patency by reducing its pressure gradient, leading to its ultimately thrombosis, but may also sustain flow segmentally in the periphery of proximally occluded AVGs. We present a fully functional novel brachio-cephalic AVG construction by way of endovascular intervention in an iatrogenic AVF of a failed brachio-axillary AVG. The ESRD female patient on long term HD was diagnosed with an iatrogenic AVF caused likely by accidental and inadvertent piercing of the cephalic vein adjacent to her left brachio-axillary AVG, which was completely thrombosed at its distal part (venous site). She had exhausted the options of native AVFs, while the right axillary, subclavian and brachiocephalic veins as well as both internal jugular veins were occluded. Under ultrasound and fluoroscopy guidance, through a retrograde access via the distal the cephalic vein, a 6 mm x 50 mm Viabahn selfexpanding stent graft (GORE®) was inserted through the ”iatrogenic fistula” and was deployed to bridge the PTFE graft and cephalic vein, leading to a new brachio-cephalic AVG. In purely endovascular therapy terms the conversion performed using a significant complication of an AVG, which had failed after brief deterioration of its access function, highlights the value of comprehensive and insightful assessment of the anatomical and haemodynamic elements available and the importance of breakthrough thinking as to the application of endovascular technologies, particularly in the paucity of AVF or AVG options in HD individuals deprived of venous conduits.
Vascular AccessUltrasound-Guided Endovascular Salvage of an Immature Radial-Cephalic AVF in a CKD Patient
By: Konstantinos Roditis
Aims: To describe the successful endovascular salvage of a non-maturing radial-cephalic arteriovenous fistula (AVF) in a chronic kidney disease (CKD) patient using an entirely ultrasound-guided percutaneous transluminal angioplasty (PTA) technique. Methods: A 57-year-old male with stage 4 CKD presented six weeks after AVF creation with poor maturation. Duplex ultrasound revealed a focal stenosis of the cephalic vein 2 cm distal to the anastomosis. Under local anesthesia and ultrasound guidance, PTA was performed using Seldinger’s technique via a 4F sheath and a 0.018” guidewire. A 4 mm focused-force scoring balloon (Ultrascore, BD) was used for dilation. The procedure was performed entirely without fluoroscopy or contrast. Results: Immediate post-procedural duplex ultrasound confirmed restoration of laminar flow and significant improvement in AVF diameter. Follow-up duplex at two weeks demonstrated continued patency and satisfactory maturation, allowing progression toward functional dialysis access. No peri-procedural complications occurred. Conclusions: Ultrasound-guided PTA using a scoring balloon is a safe and effective method for early salvage of immature AVFs. This radiation- and contrast-free approach is particularly suitable for CKD patients and can significantly improve AVF maturation rates while minimizing procedural risk.
Vascular AccessA Modified Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (mMILLER) Technique: A Case Series
By: Jose Miguel Vilas Boas
This poster depicts a case series on the use of a modified Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique to address high-flow vascular access and hemodialysis access-induced distal ischemia (HAIDI). The study reports on four patients treated with this modified technique between January and May 2024, where a novel approach was applied to effectively reduce venous access flow to desired levels. The results indicated complete symptom resolution and successful access flow reduction in all cases, with no significant complications noted. This study emphasizes the modified MILLER technique as a safe, effective alternative to other banding methods, highlighting the need for further research with larger patient cohorts to confirm its efficacy and safety.
Vascular AccessRecognizing and Managing Ischemic Monomelic Neuropathy: A Clinical Case
By: Jose Miguel Vilas Boas
The abstract discusses a clinical case of ischemic monomelic neuropathy (IMN), a rare but serious complication following the creation of arteriovenous grafts (AVG), which can result in significant sensory and motor dysfunction in the limb. The case involves a 79-year-old male patient with end-stage renal disease and diabetes who developed severe pain and deficits in hand function shortly after undergoing axillo-axillary AVG surgery. Prompt diagnosis of IMN was made based on clinical symptoms and signs, leading to urgent AVG closure. While the patient experienced some improvement in finger movement post-surgery, residual sensory and pain issues persisted. The abstract emphasizes the diagnostic challenges and potential risk factors for IMN, highlighting the necessity for prompt intervention by vascular surgeons to mitigate lasting neurological damage.
Vascular AccessShowing 16 of 16 submissions