Sharp needle reconstructs peripheral outflow for patients with malfunctional arteriovenous fistula.

OBJECTIVE: To investigate the feasibility and efficacy of combining ultrasound-guided sharp needle technique with percutaneous transluminal angioplasty (PTA) for treating outflow stenosis or dysfunction in arteriovenous fistula (AVF) among hemodialysis patients. METHODS: From October 2021 to March 2023, patients with occluded or malfunctional fistula veins not amenable to regularly angioplasty were retrospectively enrolled in the study. They underwent ultrasound-guided sharp needle intervention followed by PTA. Data on the location and length between the two veins, technical success, clinical outcomes, and complications were collected. Patency rates post-angioplasty were calculated through Kaplan-Meier analysis. RESULTS: A total of 23 patients were included. The mean length of the reconstructed extraluminal segment was 3.18 cm. The sharp needle opening was performed on the basilic vein (60.9%), brachial vein (26.1%), or upper arm cephalic vein (13%) to create outflow channels. Postoperatively, all cases presented with mild subcutaneous hematomas around the tunneling site and minor diffuse bleeding. The immediate patency rate for the internal fistulas was 100%, with 3-month, 6-month, and 12-month patency rates at 91.3%, 78.3%, and 43.5%, respectively. CONCLUSION: Sharp needle technology merged with PTA presents an effective and secure minimally invasive method for reconstructing the outflow tract, offering a new solution for recanalizing high-pressure or occluded fistulas.

A randomised, double-blind, placebo-controlled trial on the effect of Pycnogenol on the climacteric syndrome in peri-menopausal women.

BACKGROUND: French maritime pine bark extract (Pycnogenol) was found to alleviate menstrual pain and reduce hyperactivity in clinical studies. These results suggest the possibility to observe positive effects in treating climacteric syndrome. OBJECTIVE: Clinical investigation of the effect of Pycnogenol, French maritime pine bark extract, on the climacteric syndrome. METHODS: Some 200 peri-menopausal women were enrolled in a double-blind, placebo-controlled study, and treated with Pycnogenol (200mg) daily. Climacteric symptoms were evaluated by the Women's Health Questionnaire (WHQ), patients were checked for antioxidative status and routine chemistry. A total of 155 women completed the study. RESULTS: All climacteric symptoms improved, antioxidative status increased and LDL/HDL ratio was favourably altered by Pycnogenol. No side effects were reported. CONCLUSION: Pycnogenol may offer an alternative method to reducing climacteric symptoms without unwanted effects.