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Journal of Indonesia Vascular Access
Published by Indonesian Vascular Access Association
ISSN : 28077032     EISSN : 27986780     DOI : https://doi.org/10.51559/jinava
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology
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
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Negative Pressure Wound Therapy (NPWT)-assisted blowhole incisions in treating extensive subcutaneous emphysema: a literature review Amestris, Eirene
Journal of Indonesia Vascular Access Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v5i2.83

Abstract

Background: Subcutaneous emphysema (SE) is defined as the generation or infiltration of air in the subcutaneous tissues (beneath the dermal layer) of skin, cause by various etiologies. Untreated extensive SE can lead to respiratory and cardiovascular collapse. There are various treatments for treating SE. Blowhole incisions are considered one of the minimally invasive methods, with their variation by combining the incision with the usage of negative wound pressure therapy (NPWT). This literature study aims to evaluate the NPWT blowhole incisions in treating extensive subcutaneous emphysema Methods: Literature was sourced from PubMed, ProQuest, and Google Scholar databases. This review used case reports, case series, and systematic reviews, and each study underwent quality appraisal with the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. In this study, we will compare the various settings used in NPWT-assisted blowhole incisions in treating extensive SE and the outcomes from the method used. The final list for review consisted of 14 studies. Results: Fourteen studies met the inclusion criteria. The most common causes of extensive subcutaneous emphysema were pneumothorax and rib fractures following chest trauma. The most frequently applied intervention was bilateral infraclavicular blowhole incisions measuring 3–5 cm, combined with NPWT at approximately −125 mmHg. Regression of subcutaneous emphysema, assessed clinically and/or with chest X-ray or CT, was typically observed within the first 24 hours, with NPWT removal possible after 96 hours. No complications or recurrences were reported across the included studies. Conclusion: NPWT-assisted blowhole incisions are a minimally invasive, safe, and effective method for managing extensive SE. Bilateral infraclavicular incisions measuring 3–5 cm combined with NPWT at continuous −125 mmHg appear to be a practical approach, typically resulting in regression within 4–72 hours, with device removal often after 96 hours. No significant complications or deaths were reported. The technique’s low cost, minimal infection risk, and practicality make it a viable alternative to more invasive interventions.
Risk factors associated with the incidence of Arteriovenous (AV) shunt stenosis in Chronic Kidney Disease (CKD) patients on hemodialysis Gunawan, Atma; Rifai, Achmad; Kurnianingsih, Novi; Haryanto, Ahmad Farid
Journal of Indonesia Vascular Access Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v5i2.84

Abstract

Background: Arteriovenous (AV) shunt stenosis is a significant complication in chronic kidney disease (CKD) patients undergoing hemodialysis with AV shunt access. The risk factors associated with this event are still not fully understood. This study aims to identify factors associated with the incidence of AV shunt stenosis in CKD patients undergoing dialysis. Methods: A cross-sectional study was conducted involving 236 patients undergoing hemodialysis at Dr. Saiful Anwar General Hospital, Malang. Risk factors analyzed included age, gender, diabetes mellitus, hypertension, obesity, and AV shunt location. Results: Bivariate analysis using the Chi-square test showed significant associations between stenosis and age (p=0.020), gender (p=0.001), diabetes mellitus (p=0.001), and hypertension (p=0.031). However, obesity (p=0.608) and AV shunt location (p=0.552) were not significantly associated. Logistic regression analysis indicated that diabetes mellitus increased the risk of AV shunt stenosis by 2.46 times (95% CI: 1.42-4.26), hypertension by 2.05 times (95% CI: 1.06-3.96), and age above 60 years by 1.93 times (95% CI: 1.10-3.37) Conclusion: Diabetes mellitus, hypertension, advanced age, and smoking are key risk factors for AV shunt stenosis in CKD patients undergoing dialysis
Endovascular salvage of an immature radiocephalic arteriovenous fistula: a case report Limanto, Danang Himawan; Jatiman, Thomas; Juliana
Journal of Indonesia Vascular Access Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v5i2.87

Abstract

Background: Autogenous arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis, offering superior patency and lower complication rates compared to grafts or catheters. However, non-maturation occurs in 20–40% of cases, often due to juxta-anastomotic stenosis or accessory venous runoff, leading to prolonged catheter dependence and increased morbidity. Endovascular salvage strategies such as balloon-assisted maturation (BAM) and coil embolization achieve technical success rates exceeding 90% and are now central to access preservation. Case Presentation: We report a 66-year-old male with stage V chronic kidney disease on regular hemodialysis who developed an immature left radiocephalic AVF four months post-creation, complicated by ipsilateral hand edema. Duplex ultrasonography revealed draining vein diameters of 0.42–0.54 cm and flow volumes of 130–150 mL/min. Venography confirmed juxta-anastomotic stenosis with competitive runoff into the distal cephalic vein. The patient underwent endovascular salvage consisting of coil embolization of the cephalic runoff and balloon angioplasty of the draining vein using sequential 4.0 and 6.0 mm balloons. Post-procedural venography demonstrated elimination of distal runoff and restoration of antebrachial flow. Clinically, hand edema regressed, and AVF patency was preserved. Conclusion: Combined coil embolization and angioplasty can successfully salvage immature AVFs with venous stenosis and accessory runoff. This case underscores the importance of structured duplex surveillance, early identification of failing maturation, and timely endovascular intervention to preserve autogenous vascular access.

Page 6 of 6 | Total Record : 53

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