Ehab Sorial

All Publications

• Secondary interventions in patients with implantable cardiac devices and ipsilateral arteriovenous access Dua, A., Rothenberg, K. A., Mikkineni, K., Sgroi, M. D., Sorial, E., Toca, M. MOSBY-ELSEVIER. 2019: 1242–46

  View details for DOI 10.1016/j.jvs.2018.12.029

  View details for Web of Science ID 000486615200031

• Oakes Salvage Procedure Is a Better, More Durable Option Compared With Forearm Loop Expanded Polytetrafluoroethylene Graft to Preserve Forearm Dialysis Access in Patients With Failing Brescia-Cimino Fistula Lavingia, K., Dua, A., Colvard, B., Itoga, N. K., Deslarzes-Dubuis, C., Garcia-Toca, M., Sorial, E. MOSBY-ELSEVIER. 2019: E242–E243

  View details for DOI 10.1016/j.jvs.2019.04.363

  View details for Web of Science ID 000469220300355

• Secondary interventions in patients with implantable cardiac devices and ipsilateral arteriovenous access. Journal of vascular surgery Dua, A., Rothenberg, K. A., Mikkineni, K., Sgroi, M. D., Sorial, E., Toca, M. G. 2019

  Abstract

  OBJECTIVE: The number of patients with end-stage renal disease who require implantable cardiac devices is increasing. Rates of secondary interventions or fistula failure are not well studied in patients who have arteriovenous fistula (AVF) access placed on the ipsilateral side as a pacemaker. This study aimed to compare central vein-related interventions and failure rates of arteriovenous access in patients with pacemakers placed on the ipsilateral vs contralateral side.METHODS: A retrospective review of a prospectively collected database at a single high-volume dialysis institution was performed; all patients 18years or older who had both arteriovenous access and a pacemaker were included. Data points included the number of interventions such as thrombectomy, percutaneous transluminal angioplasty, and stent placement, as well as time to first intervention and failure of the fistula or graft. Patients with an implantable cardiac device who had contralateral AVF access were compared with AVF ipsilateral access using a t-test and Kaplan-Meier curves for primary patency. Outcomes evaluated included number of interventions and time to intervention from access creation.RESULTS: A total of 32 patients were identified; 20 had arteriovenous access on the contralateral side from the pacemaker and 12 had access on the ipsilateral side. In the contralateral group, there were a mean of 3.6 percutaneous transluminal angioplasties per patient (range, 1-12). In the ipsilateral group, there were an average of 2.8 percutaneous transluminal angioplasties per patient (range, 1-6). There was no difference in intervention rates between these cohorts; however, the time to intervention was increased in patients who had arteriovenous access on the contralateral side to their pacemaker (9.5 vs 19.5months; P< .05). Patency rates did not differ (P= .068).CONCLUSIONS: There was no difference in intervention rates between ipsilateral and contralateral patients; however, the time to intervention was increased in patients who had arteriovenous access on the contralateral side to their pacemaker (9.5months vs 19.5months). This study was limited by its lack of power. Patency rates did not differ (P= .068). Ipsilateral access placement should be considered rather than abandoning access in that extremity.

  View details for PubMedID 30850286

• Arteriovenous Fistula and Graft Construction in Patients with Implantable Cardiac Devices: Does Side Matter? Sgroi, M. D., McFarland, G., Itoga, N. K., Sorial, E., Garcia-Toca, M. ELSEVIER SCIENCE INC. 2019: 66–71

  View details for DOI 10.1016/j.avsg.2018.10.003

  View details for Web of Science ID 000452541600010

• Long-term durability of Oakes salvage procedure to preserve Brescia-Cimino arteriovenous fistula. Journal of vascular surgery Dua, A. n., Rothenberg, K. A., Lavingia, K. n., Oakes, D. D., Sorial, E. n., Garcia-Toca, M. n. 2019

  Abstract

  In 2002, Oakes et al described a novel procedure designed to salvage the distal cephalic venous outflow of a Brescia-Cimino fistula by placing a prosthetic graft between the brachial artery in the antecubital space and the cephalic vein at the wrist. In this fashion, the more proximal veins were saved for future procedures. Their approach was reported and found to be successful in the short term, but the long-term durability of the Oakes procedure has not been described. This study aimed to determine the long-term primary, primary-assisted, and secondary patency rates of the brachial to distal cephalic vein Oakes procedure.This is a retrospective review of a prospective database in a large, single institution. All patients who underwent the Oakes procedure from 1998 to 2012 were followed up to 2018. We reviewed the time to intervention, type of intervention, patency rates, and mortality of this patient population.Over the 5-year study period, 14 patients were identified who underwent the Oakes procedure, of whom seven (50%) were female. The average age was 55.7 years (range, 38-73 years). All patients had a previously placed Brescia-Cimino that was not suitable for dialysis but was patent. The average number of days to placement of an Oakes brachial to distal cephalic graft was 396 (range, 119-1167) days. A total of 71% (10) of patients underwent an intervention to maintain the graft, of whom 50% (5) underwent an angioplasty and 50% (5) had a thrombectomy/revision procedure. The average number of days to first intervention was 367.3 (range, 21-1048) days from Oakes placement. Of this cohort, 30% (3) of patients had a second intervention, of whom 1 (33%) underwent an angioplasty and 2 (66%) had revisions. One patient had a third and a fourth intervention at 39 days and 74 days, respectively, that were both angioplasties. The overall number of days the Oakes procedure remained usable from placement was 843.6 (range, 21-3790) days or 2.3 years.This study concluded that the Oakes procedure may extend the use of the distal dialysis access site by 2.3 years without increasing infection and is hence a durable solution that should be considered in patients requiring dialysis access.

  View details for DOI 10.1016/j.jvs.2018.12.034

  View details for PubMedID 30837176

• Arteriovenous Fistula and Graft Construction in Patients with Implantable Cardiac Devices: Does Side Matter? Annals of vascular surgery Sgroi, M. D., McFarland, G., Itoga, N. K., Sorial, E., Garcia-Toca, M. 2018

  Abstract

  BACKGROUND: Limited reports have documented the effect cardiac implantable electronic devices (CIEDs) have on arteriovenous (AV) access patency. Current recommendations suggest placing the access on the contralateral side of the CIEDs, as there is concern for increased central venous stenosis and access failure. The goal of this study is to review our single-center AV access patency rates for dialysis patients with an ipsilateral or contralateral side CIED.METHODS: A retrospective review was performed from 2008 to 2016 at a single institution identifying all patients who have received a CIED and the diagnosis of end-stage renal disease (ESRD). Medical records were queried to identify each patient's dialysis access and whether it was ipsilateral or contralateral to the CIED. Primary outcomes of study were primary and secondary patency rates.RESULTS: A total of 44 patients were identified to have ESRD and CIED. Of these patients, 28 patients with fistulas or grafts (13 ipsilateral and 15 contralateral) had follow-up with regards to their AV access. There were 3 primary failures in both groups. For patients who had the CIED placed after already starting the dialysis, patency was based on when the cardiac device was implanted. Primary patency for ipsilateral and contralateral access was 20.2 and 22.2months, respectively. With secondary interventions, ipsilateral and contralateral mean patency was 39 and 48.8months, respectively. Six-month and 1-year primary patency for arteriovenous fistula or arteriovenous graft on patients with ipsilateral access was 69.2% and 53.8%, respectively. Ipsilateral 1-year cumulative patency was 39months.CONCLUSIONS: CIED may lead to stenosis or occlusion to one's AV access; however, primary assisted and secondary patency rates are still acceptable at 6months and 1year compared to Kidney Disease Outcomes Quality Initiative guidelines. Despite a CIED, a surgeon's algorithm should not lead to the abandonment of an ipsilateral access if the central venous system is patent.

  View details for PubMedID 30339901

• Comparison of Bovine Carotid Xenograft Versus Expanded Polytetrafluoroethylene Grafts for Forearm Loop Hemodialysis Access Colvard, B., Lavignia, K., Ho, V. T., Itoga, N., Dua, A., Harris, E., Me, M., Sorial, E., Garcia-Toca, M. MOSBY-ELSEVIER. 2018: E35

  View details for Web of Science ID 000442339800065

• Secondary Interventions in Patients With Implantable Cardiac Devices and Ipsilateral Arteriovenous Access Dua, A., Sgroi, M., Lavingia, K., Rothenberg, K. A., Mikkineni, K., Sorial, E., Garcia-Toca, M. MOSBY-ELSEVIER. 2018: E6–E7

  View details for Web of Science ID 000439318700008

• Comparison of Secondary Intervention Rates in Patients With Implantable Cardiac Devices and Ipsilateral Versus Contralateral Arteriovenous Access Dua, A., Sgroi, M., Lavingia, K., Rothenberg, K. A., Sorial, E., Garcia-Toca, M. MOSBY-ELSEVIER. 2018: E125

  View details for Web of Science ID 000433036700148

• Mycotic Renal Artery Aneurysm Presenting as Critical Limb Ischemia in Culture-Negative Endocarditis CASE REPORTS IN SURGERY Vy Thuy Ho, Itoga, N. K., Wu, T., Sorial, E., Garcia-Toca, M. 2018: 7080813

  Abstract

  Mycotic renal artery aneurysms are rare and can be difficult to diagnose. Classic symptoms such as hematuria, hypertension, or abdominal pain can be vague or nonexistent. We report a case of a 53-year-old woman with a history of intravenous drug abuse presenting with critical limb ischemia, in which CT angiography identified a mycotic renal aneurysm. This aneurysm tripled in size from 0.46 cm to 1.65 cm in a 3-week interval. Echocardiography demonstrated aortic valve vegetations leading to a diagnosis of culture-negative endocarditis. The patient underwent primary resection and repair of the aneurysm, aortic valve replacement, and left below-knee amputation after bilateral common iliac and left superficial femoral artery stenting. At 1-year follow-up, her serum creatinine is stable and repaired artery remains patent.

  View details for PubMedID 29854544

  View details for PubMedCentralID PMC5964565