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Background: The radial artery deviation and reimplantation (RADAR) technique uses an artery-to-vein (end-to-side) configuration. We have developed a modified RADAR (M-RADAR) technique. This new technique enables a side-to-side anastomosis between the vessels, and furthermore, the distal cephalic vein is ligated. The VAC Study (Paradigm Shift in Vascular Access Creation) is a multicenter randomized controlled trial comparing the clinical outcomes of radiocephalic fistula created using the conventional technique (CT group) versus the modified RADAR method (M-RADAR group).
Methods: Prospective, multicenter, randomized study starting in December 2024. Participant recruitment has commenced. All data are collected via paper-based Case Report Forms (CRFs). The primary clinical endpoints include the 1-year primary patency rate of AVF and the incidence of venous juxta-anastomotic stenosis. Secondary endpoints include the 1-year access-assisted primary patency, access cumulative patency, hospitalization rates, mortality, and an analysis of the economic costs associated with maintaining vascular access. An estimated 408 participants will be recruited from approximately 29 dialysis units across China.
Discussion: A high-quality, adequately powered multicenter randomized controlled trial (RCT) is still needed to provide clear guidance for clinicians on selecting optimal treatment strategies for the cephalic vein during AVF surgery.
Trial Registration: Registration number: ChiCTR2400093537, Registered on 2024-12-06.
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http://dx.doi.org/10.1177/11297298251321983 | DOI Listing |
Eur J Clin Pharmacol
September 2025
Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, 34000, Kragujevac, Serbia.
Background: Heparin-induced thrombocytopenia (HIT) is a severe primary hypercoagulable disorder, particularly concerning in hemodialysis (HD) patients frequently exposed to heparin. Fondaparinux has emerged as a potential alternative anticoagulant, though supporting evidence is limited. This systematic review aimed to evaluate the safety and efficacy of fondaparinux in HD patients with HIT.
View Article and Find Full Text PDFJ Pediatr Urol
August 2025
Department of Paediatric Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600116, India. Electronic address:
Introduction/aims: We hereby report a novel vesicoscopic supra trigonal ureteric reimplantation detrusorraphy (STURDY) technique for unilateral duplex systems with vesicoureteric reflux (VUR).
Methods: A 3-year-old boy and a 1-year-old girl with recurrent urinary tract infections (UTIs) and left duplex VUR/ureterocele underwent vesicoscopic STURDY.
Technique: After establishing pneumovesicum, a vertical incision was made cranially along the ureter for 2-3 cm incising both the mucosa and detrusor, preserving the vas deferens.
Ophthalmic Plast Reconstr Surg
September 2025
Carotid-cavernous fistulas (CCF) are indirect or direct vascular shunts between vessels of the cavernous sinus and the carotid artery. While indirect CCFs have high rates of spontaneous resolution, direct CCF cases can result in significant orbital and neurological sequelae. This case describes a 75-year-old male patient presenting with acute subarachnoid hemorrhage secondary to a Barrow type-D CCF.
View Article and Find Full Text PDFTurk J Pediatr
September 2025
Department of Anesthesiology, All India Institute of Medical Sciences, Patna, India.
Background: Umbilical arterial catheterisation is a common intervention performed in the neonatal intensive care unit (NICU) especially in extremely preterm and extremely low birth weight neonates. Rarely catheter fracture or breakage can occur, leaving behind part of the catheter in the aorta. A handful of cases have been reported in the literature, with the majority being managed surgically.
View Article and Find Full Text PDFCNS Drugs
September 2025
Global Health Neurology Lab, Sydney, NSW, 2150, Australia.
Acute ischemic stroke (AIS) remains a leading cause of mortality and long-term disability globally, with survivors at high risk of recurrent stroke, cardiovascular events, and post-stroke dementia. Statins, while widely used for their lipid-lowering effects, also possess pleiotropic properties, including anti-inflammatory, endothelial-stabilizing, and neuroprotective actions, which may offer added benefit in AIS management. This article synthesizes emerging evidence on statins' dual mechanisms of action and evaluates their role in reducing recurrence, improving survival, and mitigating cognitive decline.
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