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Robert Shahverdyan
dedicated vascular access surgeon, loving “father of dragons“ and proud husband of PhD 😊. views are my own
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Robert Shahverdyan retweeted
Vascupedia 21h
I-VAS, International Vascular Access Symposium Fr. 13th Sep 2019, Paris🇫🇷 Submit your Abstract: Website:
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Robert Shahverdyan Jun 24
Replying to @ReidRavin
Well said!
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Robert Shahverdyan Jun 24
Yeah, have same problem in most of our dialysis units in Hamburg. Mostly time sparing and stubbornness than missing US machine. Sometimes have to locate or coil a branch, but mostly they manage it good
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Robert Shahverdyan Jun 24
Total flow is measured in the brachial artery. Size of the outflow vein tells us mostly how much flow goes where. A measurement on the vein is IMO too unreliable. Decision to start cannulations (trying with US if difficult) is based on the size of the vein mostly.
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Robert Shahverdyan Jun 24
Also the shared flow makes it bit difficult to start cannulations without US, yet keeps the cannulated veins under low pressure and we see no aneurysms or high-flow avf so far.
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Robert Shahverdyan Jun 24
In Ellipsys, mostly the EndoAv anastomosis occluded. That makes it possible to create a surgical proximal FA AVF (such as Gracz) without a problem. Persistent flow through the deep veins seems to be the key keeping them patent. (Again, 1,5 years experience, no 5-10).
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Robert Shahverdyan Jun 24
Yes, you’re correct, the veins are same (except if you do a brachial vein transposition in patients without adequate superficial UA veins. Can’t give you 5-10 y. results, but for now: most of WavelinQ EndoAVF fail due to juxtaanastomotic radial/ulnar vein (using 4F System in EU)
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Robert Shahverdyan Jun 24
I would rather say (based on personal experience as a surgeon doing sAVF and (both) EndoAVF: it’s an addition to sAVF due to location (both WavelinQ and Ellipsys), e.g. pts with failed W can still get E and both can get sAVF, so they get an extra option for a functioning access.
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Robert Shahverdyan Jun 24
What bothers me 1) the anastomosis is not really distal to the perforator as far as I can tell from the images, so the flow from the ulnar artery to the cephalic vein goes through a „painful“ way. 2) both brachials are coiled so would love to hear about maturation and congestion
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Robert Shahverdyan Jun 23
A „High-flow“ week at the Hamburg: 3 cases of banding procedures done using from ⁩ ⁦⁩ ⁦⁩ ⁦⁩ ⁦⁩ ⁦
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Robert Shahverdyan Jun 23
Emotional violence in childhood, adolescence associated with suicidal thoughts via
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Robert Shahverdyan Jun 22
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Robert Shahverdyan Jun 22
Looks great!!!!!
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Robert Shahverdyan Jun 21
Definitely EndoAVF vs sAVF 😉
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Robert Shahverdyan Jun 19
Replying to @MyJea3
Thanks for the comment, but let‘s agree to disagree...
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Robert Shahverdyan Jun 19
Replying to @aishaikh @wasse_m and 3 others
Great, thanks. Happy to hear it confirms my plan, although my nephrologist and cardiologist are totally freaked out and want to put him on Apixaban ASAP
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Robert Shahverdyan Jun 19
Replying to @aishaikh @wasse_m and 3 others
Thanks Aisha, same here... 👍🏻👍🏻👍🏻 Any thoughts about the necessity of anticoagulation?
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Robert Shahverdyan retweeted
Brian Driscoll Jun 19
Vascular surgeon presented data at SVS on 216 patients who successfully received AV fistulae via Avenu Medical's Ellipsys system.
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Robert Shahverdyan Jun 19
Replying to @mms62786 @DanHan
Pride and being totally lazy....
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Robert Shahverdyan Jun 19
Replying to @robshahverdyan
So, the patient is fully asymptomatic, there is no minderperfusion of the lung or thrombi at the coils (the right one is probably 6 weeks old). Treatment options? Full anticoagulation? - Patient has huge kidney cysts. Try take it out with snare? - more damage than help? Advice?
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