TY  - JOUR
A1  - Augustin, Anne Marie
A1  - Kertels, Olivia
A1  - Wiegering, Verena
A1  - Thurner, Annette
A1  - Kickuth, Ralph
T1  - Percutaneous implantation of peripherally inserted totally implantable venous access systems in the forearm in adolescent patients
JF  - Pediatric Radiology
N2  - Background
Children with different underlying malignant diseases require long-term central venous access. As for port systems in a pectoral position, peripherally implanted port systems in the forearm revealed high levels of technical and clinical success in adult cohorts.

Objective
To investigate the technical and clinical outcomes of percutaneous central venous port implantation in the forearm in adolescents.

Materials and methods
Between April 2010 and August 2020, 32 children ages 9 to 17 years with underlying malignancy received 35 totally implantable venous access ports (TIVAPs) in the forearm. All venous port systems were peripherally inserted under ultrasound guidance. Correct catheter placement was controlled by fluoroscopy. As primary endpoints, the technical success, rate of complications and catheter maintenance were analyzed. Secondary endpoints were the side of implantation, vein of catheter access, laboratory results on the day of the procedure, procedural radiation exposure, amount of contrast agent and reasons for port device removal.

Results
Percutaneous TIVAP placement under sonographic guidance was technically successful in 34 of 35 procedures (97.1%). Procedure-related complications did not occur. During the follow-up, 13,684 catheter days were analyzed, revealing 11 complications (0.8 per 1,000 catheter-duration days), Of these 11 complications, 7 were major and 10 occurred late. In seven cases, the port device had to be removed; removal-related complications did not occur.

Conclusion
Peripheral TIVAP placement in the forearms of children is a feasible, effective and safe technique with good midterm outcome. As results are comparable with standard access routes, this technique may be offered as an alternative when intermittent venous access is required.
KW  - adolescents
KW  - central venous catheter
KW  - children
KW  - forearm
KW  - interventional radiology
KW  - totally implantable venous access port
KW  - vascular access
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324947
VL  - 52
IS  - 8
ER  - 
TY  - JOUR
A1  - Ocak, Gurbey
A1  - Drechsler, Christiane
A1  - Vossen, Carla Y.
A1  - Vos, Hans L.
A1  - Rosendaal, Frits R.
A1  - Reitsma, Pieter H.
A1  - Hoffmann, Michael M.
A1  - März, Winfried
A1  - Ouwehand, Willem H.
A1  - Krediet, Raymond T.
A1  - Boeschoten, Elisabeth W.
A1  - Dekker, Frido W.
A1  - Wanner, Christoph
A1  - Verduijn, Marion
T1  - Single Nucleotide Variants in the Protein C Pathway and Mortality in Dialysis Patients
JF  - PLOS ONE
N2  - Background: The protein C pathway plays an important role in the maintenance of endothelial barrier function and in the inflammatory and coagulant processes that are characteristic of patients on dialysis. We investigated whether common single nucleotide variants (SNV) in genes encoding protein C pathway components were associated with all-cause 5 years mortality risk in dialysis patients. 
Methods: Single nucleotides variants in the factor V gene (F5 rs6025; factor V Leiden), the thrombomodulin gene (THBD rs1042580), the protein C gene (PROC rs1799808 and 1799809) and the endothelial protein C receptor gene (PROCR rs867186, rs2069951, and rs2069952) were genotyped in 1070 dialysis patients from the NEtherlands COoperative Study on the Adequacy of Dialysis (NECOSAD) cohort) and in 1243 dialysis patients from the German 4D cohort. 
Results: Factor V Leiden was associated with a 1.5-fold (95% CI 1.1-1.9) increased 5-year all-cause mortality risk and carriers of the AG/GG genotypes of the PROC rs1799809 had a 1.2-fold (95% CI 1.0-1.4) increased 5-year all-cause mortality risk. The other SNVs in THBD, PROC, and PROCR were not associated with 5-years mortality. 
Conclusion: Our study suggests that factor V Leiden and PROC rs1799809 contributes to an increased mortality risk in dialysis patients.
KW  - human brian endothelium
KW  - factor-V-Leiden
KW  - venous thrombosis
KW  - activated receptor-1
KW  - vascular access
KW  - severe sepsis
KW  - gene polymorphism
KW  - organ dysfunktion
KW  - ischemic stroke
KW  - renal disease
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-116265
SN  - 1932-6203
VL  - 9
IS  - 5
ER  -