Predictors of Angio access failure in end stage renal disease patients in Southern Egypt

Background: Hemodialysis (HD) seems to be the most often used Renal Replacement Therapy (RRT) modality worldwide, and it is the primary modality in the majority of instances with extended RRT. The ability to provide our patients with high-quality HD treatment while also increasing their chances of survival is heavily reliant on the functionality of the vascular access (VA). Despite the fact that it is a very necessary component of all clinical practise standards, it is the most expensive individual component of RRT.Objectives: This study was aimed at comparing between the group with Angio access failure and group without Angio access failure and predicting Angio access failure among end stage renal failure patients in Southern Egypt.Subjects and Methods: a prospective cohort study among 125 patients with end stage renal failure at Aswan University. The research comprised patients who had NCVA placement [intra-atrial catheter (IAC) and trans-lumbar catheter (TLC)] between January 1, 2020, and December 31, 2020.Results: The duration of previous RRT was significantly higher among the Angio access failure than the group without Angio access failure. In multivariate analysis using logistic regression, the age, duration of previous RRT, diabetes, IHD (ischemic heart disease), PVD (peripheral vascular disease) and CVD (cardiac vascular disease) were significantly direct predictors of the Angio access failure in the first one year.Conclusion: In conclusion the failure of Angio access was positively associated with age, previous RRT and other comorbidities

Endovenous Laser Ablation, Radiofrequency Ablation and Flebogrif versus Conventional Surgery in Treatment of Primary Varicose Vein of the Lower Limb: Prospective Randomized Controlled Study

Background: Endovenous laser ablation (EVLA), radiofrequency ablation (RFA) and mechanochemical ablation (MOCA) of primary varicose vein are thought to minimise postoperative morbidity and reduce work loss compared with the conventional surgical procedure. Objective: To determine, whether endovenous ablation methods (radiofrequency, laser and mechanochemical) have any advantages or disadvantages in comparison with conventional surgery, in the treatment of primary varicose vein. Patients and Methods: This was a prospective randomized study, conducted on forty patients presented at Vascular Outpatient Clinic for management of chronic venous insufficiency. All patients underwent clinical examination and duplex ultrasonography. Ten (10) patients were treated with ligation and stripping of the great saphenous vein (GSV). Ten (10) patients were treated with radiofrequency ablation. Ten (10) patients were treated with endovenous laser ablation. Ten (10) patients were treated with Flebogrif. Results: Compared with conventional surgery, endovenous ablation methods reduced postoperative discomfort and pain, with a lower complication rate after treatment for avoidance of a groin incision and dissection at the saphenofemoral confluence. Cosmetic demands were also better satisfied. Non-controlled clinical trials have shown that the ablation rate of GSV after EVLA is over 90%. However, risks of EVLA, RFA and Flebogrif remain in terms of recanalization and neoreflux via junctional tributaries. Conclusion: RFA, EVLA, and Flebogrif are minimally invasive procedures. Their potential early benefits, by avoiding groin dissection and GSV stripping, have been confirmed by the findings from this trial. Current evidence based on randomized trials consistently demonstrates significant early benefits after RFA, EVLA and Flebogrif in suitable patients with varicose veins