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Indra Prasetya
Brawijaya Cardiovascular Research Center

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Central Vein Stenosis in Patient with Routine Haemodialysis: From Diagnosis and Prompt Treatment A Case Report Yudi Putra Apriditya; Novi Kurnianingsih; Djanggan Sargowo; Indra Prasetya
Heart Science Journal Vol 3, No 4 (2022): Prevention, Screening dan Rehabilitation : The Back Bone of Quality Care Improve
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.04.8

Abstract

Central vein stenosis (CVS) is common in hemodialysis patients caused by the implantation of cardiac intravascular devices, venous access, and limited vascular access. Until an arteriovenous fistula (AVF) or graft is established in the ipsilateral arm or forearm for hemodialysis, the effect may develop. Arm edema, significant venous dilatation, and recurring infections are common complications of having an ipsilateral arteriovenous fistula or graft. We present the case of a 50-year-old female who developed symptomatic CVS while being on regular hemodialysis. A venography using a catheter revealed a significant stenosis of the subclavian vein. Due to central venous stenosis, this patient had substantial edema of her left arms after undergoing an ipsilateral arteriovenous graft. Multiple endovascular treatments have failed to alleviate the symptoms. The incidence and danger of central vein stenosis in hemodialysis patients are discussed, as well as the success of endovascular therapies. The initial line of therapy should be percutaneous balloon angioplasty. Unfortunately, after angioplasty or stenting, primary patency is poor. If there is recurring stenosis, the procedure can be repeated.
Risk Factors for Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Yudi Putra; Budi Satrijo; Setyasih Anjarwani; Indra Prasetya; Anna Fuji Rahimah
Heart Science Journal Vol 4, No 1 (2023): Optimizing Outcome in Acute Cardiac Care
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.01.5

Abstract

BackgroundAcute kidney injury (AKI) is a frequent complication of ST-Elevation Myocardial Infarction (STEMI). AKI occurs in about 10% to 20% of patients with STEMI, which significantly impacts both short-term and long-term clinical outcomes.ObjectivesWe purposed to identify the risk factors for AKI among STEMI patients undergoing Primary PCI.MethodsThis retrospective cohort study analyzed 568 STEMI patients who underwent Primary PCI from 2017 to July 2022 at Saiful Anwar General Hospital Malang. We conducted both univariate and multivariate studies to determine AKI risk factors.ResultsThe risk factors for AKI among STEMI patients undergoing primary PCI were identified. The OR values for each were as follows: Shock condition (OR = 1.41; 95% CI = 1.18 – 1.92); Killip ≥3 (OR = 3.54; 95% CI = 2.14 – 4.26); and total contrast volume> 145 ml (OR = 1.61; 95% CI = 1.13 – 1.92). Based on the ROC curve analysis, total contrast volume >145 ml with an area under the curve (AUC) of 0.75 (95% CI = 0.65-0.85) with a specificity of 0.66 (95% CI = 0.61 – 0.71) and a sensitivity of 0.71 (95% CI = 0.65-0.76).ConclusionOur study revealed that the risk factors for AKI among STEMI patients undergoing primary PCI were shock condition, Killip class ≥3, and total contrast volume >145 ml.