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Ketut Putu Yasa
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INDONESIA
Journal of Indonesia Vascular Access
ISSN : 28077032     EISSN : 27986780     DOI : https://doi.org/10.51559/jinava
Core Subject : Health, Science,
Journal of Indonesia Vascular Access; peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the field. INAVA publishes articles that encompass basic research/clinical studies related to the cardiovascular and thorax field. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship and encourage a vigorous dialogue between medical scholars and practitioners.
Arjuna Subject : Kedokteran - Pembedahan
Articles 53 Documents
Rupture infected pseudoaneurysm on brachiocephalic AV-fistula: emergency and definitive management Reza Eka Putra; Prasetyo Edi
Journal of Indonesia Vascular Access Vol. 2 No. 2 (2022): (Available Online: December 2022)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v2i2.28

Abstract

Background: Vascular access bleeding is a rare event that can be fatal in hemodialysis patients. It requires emergency and surgical management to reduce the risk of ischemic events in the patient’s forearm and reduce mortality risk. Objective: To describe the clinical presentation, emergency and surgical intervention, and outcome of rupture-infected anastomotic pseudo aneurysm of the brachiocephalic arteriovenous fistula that underwent a definitive surgical procedure. Case Description: A 55-year-old man presented with bleeding on the AV-fistula surgery site, accompanied with pain and swelling on his forearm that occurred 3 hours before admission to the hospital. The Patient had a history of brachiocephalic AV-fistula surgery 3 weeks earlier. On physical examination, It was found that the surgical site wound looked wet and swollen, with lots of necrotic tissue and pus and lost stitches. In Emergency Departments, the patient was administered intravenous normal saline fluids, bleeding inhibitors and pressure bandages to reduce ongoing bleeding. Then the patient had planned for immediate vascular reconstruction surgery. The brachial artery is repaired using great saphenous vein patch plasty. Results: The patient’s postoperative 30-days follow-up went well, and there was no sign of complication, such as pain, infection, paresthesia, bleeding at the surgical site or ischemia in the distal forearm. Conclusion: Vascular access bleeding can be fatal to hemodialysis patients. Optimal treatment for the patient's life and hemodialysis access is a top priority. A good assessment of the condition of AVF and the choice of subsequent therapy greatly affect the patient's prognosis.
Characteristics of central vein stenosis patients at Abdoel Wahab Sjahranie Hospital Samarinda Fritzky Wandy Thedjakusuma; Ramadhani Hengki Wijaya; David Hermawan Christian; Michael Caesario; Ivan Joalsen Mangara Tua
Journal of Indonesia Vascular Access Vol. 3 No. 1 (2023): (Available Online: June 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i1.29

Abstract

Background: Central vein stenosis (CVS) is a common complication in using a central venous catheter in hemodialysis (HD) access, and its incidence in Indonesia has not been obtained. This study aims to evaluate the characteristics of CVS patients in Abdul Wahab Sjahranie Hospital, Samarinda. Methods: This cross-sectional descriptive study was conducted by collecting CVS patients’ data from the medical records between January 2018 to August 2021. The demographic data and the characteristics of CVS patients were collected. The data obtained were analyzed in descriptive form and displayed in a table. Results: This study involved 23 subjects. The characteristics of CVS patients included: Highest sex group was males (61%); Age group was in the range 51-70 years (60%); Clinical feature was swelling (83%); Site of stenosis was in the subclavian vein (87%), on the left side (57%), type of occlusion were partial (67%) and single (87%), and the result of angioplasty was a success (61%). Conclusion: This study showed that CVS was male predominant, in the range 51-70 years, the most complaint was swelling in the arms that were mostly on the left side, and the location of the most stenosis was in the subclavian vein, with partial and single occlusion, as well as good treatment with angioplasty.
Angioplasty experience for central venous stenosis in hemodialysis patients: a case series Nyoman Saka Ranuartha; Danang Himawan Limanto; Ketut Putu Yasa
Journal of Indonesia Vascular Access Vol. 3 No. 1 (2023): (Available Online: June 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i1.33

Abstract

Objective: To report the treatment of central venous stenosis in hemodialysis patients with endovascular intervention angioplasty. Introduction: Central venous stenosis is a common case in patients with renal failure or end-stage renal disease who have a history of dialysis, which requires vascular access. The currently available techniques for managing central venous stenosis are endovascular intervention with angioplasty and stent placement. Although open surgical treatment has shown durability in the past, it was correlated with significant morbidity. One of the techniques describes the antegrade technique of endovascular intervention. Case description: In this study present 5 cases of central venous stenosis in patients with hemodialysis. In this case series, the patient complained that had a history of swelling in the upper arm unilateral. Diagnostic with catheterization, there was stenosis of the subclavian vein and innominate. This study performed the endovascular management experience with the preferred treatment for central venous stenosis to perform revascularization procedures which is percutaneous transluminal angioplasty (PTA) with balloon angioplasty. Conclusions: Management of central venous stenosis in patients with hemodialysis can be presented effectively and safely using angioplasty which results in low rates of complication and usually has a shorter length of stay post-procedural.
Surgical management of adult supraclavicular hemangioma: a case report Novita Sahniar S; Ivan Joalsen MT
Journal of Indonesia Vascular Access Vol. 3 No. 1 (2023): (Available Online: June 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i1.36

Abstract

Introduction: Hemangioma is one of the most common vascular anomalies. It is classified into two types: superficial hemangioma, also known as capillary hemangioma, which appears as brilliant red macular masses, and deep hemangioma, which appears as a soft, non-fluctuating, poorly defined, and occasionally bosselated nodule. Surgical excision is recommended for cavernous-type tumors, which are less sure to regress. Despite its benign origin and behavior, it can develop in any body part. However, its size and origin site may vary and make surgical excision more challenging due to the importance of the structures surrounding the mass. Thus, this study aims to explain the surgical management of adult supraclavicular hemangioma. Case Description: We present a case of primary cavernous hemangioma in 36 years-old-woman with no history of health problems that extends to the supraclavicular area and was linked to essential structures. The surgical excision was performed through a double-incision technique to prevent iatrogenic damage to the system. Postoperative evaluations revealed no impairment of motoric and sensory hand functions, and the patient was discharged three days postoperatively. Histopathologic findings were consistent with the diagnosis of hemangioma. Conclusion: The supraclavicular approach in surgery is challenging due to its critical location and closeness to key neurovascular structures. To obtain the best surgical outcome, the essential operating concepts include thorough dissection and a modified method to limit the risk of functional status and mobility impairment.
Endovascular laser ablation management of pediatric Klippel trenaunay syndrome: a case report Annisa; Ivan Joalsen MT; Michael Caesario
Journal of Indonesia Vascular Access Vol. 3 No. 1 (2023): (Available Online: June 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i1.37

Abstract

Introduction: Klippel trenaunay syndrome (KTS) is a rare and complex congenital vascular anomaly as a combination of vascular capillary malformations (port wine stain), venous malformations (VM) and excessive extremity growth with or without lymphatic malformations. The incident KTS is estimated to be 2 to 5 per 100,000 and found in the male gender without distinguishing race. This syndrome is rare, with a low incidence. Klippel trenaunay syndrome uses conservative management with the use of compression stockings. Other KTS management, such as minimally invasive intervention with endovascular laser ablation (EVLA) therapy, is rarely used due to the rare number of diseases. Thus, this study aims to perform the management of KTS in pediatrics. Case description: We report 11-year-old girls complaining of pain and swelling on the right leg when standing long and doing activities. Physical examination appears to show a purplish-red birthmark that arises on the surface of the skin. Ultrasound and CT scan angiography with contrast in the lower region extremities showed hypertrophy accompanied by peripheral branches in the cutaneous layer. Patients are performed endovascular laser ablation using general anesthesia. After endovascular laser ablation, the patient was treated for 2 days without any complaints. Conclusion: KTS is a rare, complex and varied syndrome that has not been found yet. KTS only performs symptomatic treatment depending on clinical and severity. Endovascular laser ablation is a minimally invasive intervention management that must be considered and has a fairly low risk and complication, especially in pediatrics.
Diagnostic and Management Ruptur Artery Radialis and Ulnaris Sinistra et causa Vascular Trauma : A Case Report Okthara Sebayang, Abed Nego; Ibnu, Syahroni
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.25

Abstract

Background: Vascular trauma is a life-threatening injury caused by a stab wound, blunt, or iatrogenic wound that damages a blood vessel. Vascular trauma can involve arteries and veins. Vascular trauma requires diagnosis and action fast handling to avoid fatal consequences in the form of amputation. This case report will discuss vascular trauma to the radial and ulnar arteries due to work accidents. Case Description: A 19-year-old patient came with his colleague from the Emergency Department with the chief complaint of bleeding in his left hand. The patient experienced this while working on repairing electrical pipes an hour ago. The incident began when the electric cable fell from the power pole, and then the car grabbed the power cable so that it wrapped around the patient's left hand, injuring the patient's hand and bleeding. The supporting examination was an X-ray of the upper extremity. Although the impression on the radiological examination was that the radial and ulnar bones looked good, there were soft tissue defects in the dorsal-lateral of the distal antebrachial. However, on laboratory examination, blood was within normal limits. The treatment included vascular exploration surgery, vein autograft, harvesting of vena saphena Magna for vascular reconstruction, skin graft, and debridement. During treatment, the cruris Sinistra is given light therapy to repair damaged vascularisation. Conclusion: Vascular trauma is an injury caused by a stab wound, blunt object, or iatrogenic wound that damages a blood vessel.  In this case, ruptured artery radialis and ulnaris sinistra et cause trauma was found. Therefore, the treatment was to do vascular exploration surgery, vein autograft, harvesting of vena saphena magna for vascular reconstruction, and debridement.
Successful prolonged intermittent renal replacement therapy in managing isolated coronary artery bypass graft surgery-associated acute kidney injury: A case report Huzaiby, Adam; Wardoyo, Suprayitno
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.34

Abstract

Introduction: Unstable angina pectoris is one of the most underappreciated conditions by emergency department doctors. Unfortunately, the UAP is a type of heart attack that is usually caused by the deadliest type of CAD, namely the left main disease and three-vessel diseases. Both types are excellent candidates for operative revascularization with a satisfying result. Not infrequently, the acute renal complications after CABG surgery often become catastrophic. This study aims to evaluate our experiences in managing our patients with AKI following a conventional CABG surgery as a postoperative complication. Case description: A 69-year-old man was admitted to the ward to undergo a scheduled elective CABG surgery on the following day. The patient has a history of UAP, and a CAG study that was done three weeks earlier indicated that the culprit was a left main disease. The LIMA was anastomosed to the distal segment of the LAD, and one graft of GSV was anastomosed to the OM. Following the surgery, the patient experiences an unstable rapid response of AF and stage three AKI. Eventually, the patient must undergo two times of SLEDDs. After a second dialysis, the patient’s serum creatinine was lowered and the stage of the AKI was downgraded. After close monitoring for fifteen days, the patient’s serum creatinine gradually became normal. The dialysis access is removed, and the patient does not need a subsequent routine dialysis following discharge from our hospital. Conclusion: The incidence of AKI following CABG surgery can be multifactorial. An alternative technique instead of using a CPB machine, judicious use of blood products, and prevention and treatments of a POAF should be considered. The PIRRT can be chosen as an alternative modality to CRRT with the same outcome quality for managing stage three AKI following CABG surgery.
Clinical outcomes of splenorenal shunts in esophageal varices patients: a literature review Putra, I Gusti Agung Made Adnyana; Hakim, Arief Rakhman; Soebroto, Heroe; Sembiring, Yan Efrata; Limanto, Danang Himawan; Rizki, Mohamad; Puruhito
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.40

Abstract

The disease known as esophageal varices is usually caused by portal hypertension. Portal hypertension is most commonly caused by extrahepatic portal vein thrombosis and other conditions, such as cardiac problems or hepatic cirrhosis. Clinical manifestations of esophageal varices can include melena, haematemesis, and gastrointestinal bleeding. Effective venous pressure reduction is achieved via the distal splenorenal shunt. We acquired the literature for our review from PubMed and Google Scholar. The search was done in English using terms that indicated a connection between improvements in bone grafting methods and the restoration of alveolar clefts. To expand the search results, we also looked through the papers cited in the literature. Almost all of the five gathered articles demonstrated that the distal splenorenal shunt (DSRS) is a beneficial surgical treatment that effectively avoids postoperative PH issues. Finally, DSRS is presented as a surgical long-term treatment for variceal esophageal reflux disease and portal hypertension. Because DSRS selectively decompresses the venous collaterals around the stomach and lower esophagus, it is a safe and effective therapy choice for decreasing bleeding over nonselective shunting surgeries as a selective shunt.
Amplatzer vascular plug for alternate treatment in pelvic congestive syndrome in Dr. Soetomo General Hospital: A case report Raharjo, Fumansha Cipto; Danang Himawan Limanto
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.41

Abstract

Introduction: One of the common causes of chronic pelvic pain in reproductive-age women is pelvic congestion syndrome (PCS). This pain can be constant or intermittent for 3-6 months, occurring throughout the menstrual cycle, arising in the abdominal or pelvic area, and is not related to pregnancy. Complaints of chronic pelvic pain are as much as 10-20% of gynecological consultations, and only 40% of them are referred to specialists for evaluation. 10 – 60 % of PCS is caused by insufficient iliac vein, ovarica vein, or both. Incompetent ovarian vein ligation can head to a favorable result. An endovascular technique using an embolization coil, glue, foam, or amplatzer can be an alternative treatment for PCS.  Case Description : Women 50 years old whom a history of chronic pelvic pain, CT angiography showed Left ovarica vein dilatate and prominant. Durante operation, approach from a right femoral vein with a catheter to the left renal and ovarian veins. Amplatzer vascular plug was deployed at the left ovarian vein and evaluated. There wasn’t insufficient. The Patient was discharged the day after the operation. Conclusion : In conclusion, venous occlusion with vascular plug for PCS management is safe and effective with an embolization agent or surgery with a significant enhancement in pelvic symptoms for PCS.
An unusual phenomenon of recurrent aortic dissection with hypertension: a rare case report Atthoriq Hayat Kurnia; Verry Gunawan Sohan
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.42

Abstract

Introduction: Recurrent aortic dissection is a rare and challenging phenomenon for cardiovascular cases in the world. In the last two decades among patients with initial aortic dissection, only 5% have become recurrent aortic dissection, typically seen in patients with connective tissue disorders. We report an unusual case of recurrent aortic dissection with hypertension. Case Presentation: A 55-year-old female came with complaints of chest pain from the mid and left chest to the back. The symptoms had occurred for almost three years after treatment and post-surgery of her prior aortic aneurysm dissection. But she still had the same signs and symptoms as before. We requested thoracoabdominal CT angiography to confirm the diagnosis. A thoracoabdominal CTA shows recurrent aortic dissection, because of its difficulty and rarity we need proper consideration. For now, we prefer conservative medical treatment with management of blood pressure and pain control, also treatment for other diseases. Conclusion: Recurrent aortic dissection is still a special challenge for physicians and a rare extreme phenomenon that may need a special approach and more complex treatment strategies.