http://healthnews.uc.edu/news/?/7651/
Major collaborators include Rino Munda, MD, and colleagues from the department of transplant surgery, as well as physicians and researchers from the departments of nephrology, mechanical engineering, pathology, biomedical engineering, radiology, cardiology, pharmacy and community nephrologists.
http://healthnews.uc.edu/news/?/5501/
In order to reduce the problems linked with hemodialysis vascular-access dysfunction, Roy-Chaudhury, UC surgeons Rino Munda, MD, and Steve Woodle, MD, and colleagues in engineering, radiology, cardiology and pathology have established the Cincinnati Dialysis Access Research Program (CAP).
http://healthnews.uc.edu/news/?/10585/
Clinical Trial Examines Gene Therapy for Dialysis Patients
CINCINNATI—A new gene therapy may help sustain dialysis access in patients, eliminating the need for multiple interventions and surgeries and improving their quality of life.
Timmy Lee, MD, UC Health nephrologist, and Rino Munda, MD, UC Health transplant surgeon, are leading a local branch of a national clinical trial looking at the gene therapy product Trinam to see if it prevents stenosis, or narrowing of the veins at the connection of the vein and dialysis graft, in hemodialysis patients.
[QUOTE=Dori Schatell;19791]Mark, this is exactly the point of the Buttonhole technique–cannulating in exactly the same spot, at exactly the same angle, over and over again. Done right (this means by the SAME person at the exact SAME angle–preferably the person with the fistula), this technique has been shown in research to cause fewer missed sticks and fewer aneurysms and bumps. The only problem that has been seen is a risk of infection if the scabs are not removed the right way. But infection is always a risk with any access, and good technique can prevent it.
Unfortunately, the Buttonhole technique is often done wrong:
- Staff insist on starting Buttonholes, because they don’t trust patients to use sharps, or they worry about liability. But clinics can rarely assign the same person to cannulate for as many treatments in a row are needed, so 2 or 3 or 4 different staff may try, each with a slightly different angle. This can lead to “coring” – making the hole larger and larger so blood leaks out around it during a treatment, and people say, “that Buttonhole thing doesn’t work, we tried it.” WRONG.
- Even if, by some miracle, you can get one staff person to start Buttonholes, it’s unlikely that he or she would cannulate at the same angle that YOU would. So, you’d end up with a Buttonhole that is awkward or difficult for you to use, or where the blunt needle just won’t go in the track. Then people say, “that Buttonhole thing doesn’t work. We tried it.” WRONG again.
I’m glad your doctors are so experienced, but sometimes doctors don’t keep up with what’s new (though the Buttonhole technique was actually first done about 30 years ago). Or, they don’t like change. If it were me on dialysis, I would absolutely use the Buttonhole technique. The data are persuasive, and so are the testimonies of people who use it the right way.
As far as the WAK, I suspect that SOME new machine (maybe not that one) will be on the market within 3 years or so, and there may be several within the next 5-6 years. Folks are going to have more choices relatively soon, I think![/QUOTE]