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DASy2020 Program Book

※ About Conference Event: Dialysis Access Synergy & SoDAS Annual Conference 2020 Date: Friday 13th March – Sunday 15th March 2020 Venue: Ding Garden, 2F, Fullon Hotel Linkou, Taoyuan, Taiwan ※ Live Stream on Youtube Day 1: https://www.youtube.com/watch?v=s3RoX1HEku4 Day 2: https://www.youtube.com/watch?v=nu_F0KI7s7I Day 3: https://www.youtube.com/watch?v=OJ9XWPRTaDM ※ Website: https://www.dialysisaccesssynergy.com/ ※ Contact Person Peipei Chen Email: dasy2020.tw@gmail.com Secretariat of DASy & SoDAS Annual Conference 2020

※ About Conference
Event: Dialysis Access Synergy & SoDAS Annual Conference 2020
Date: Friday 13th March – Sunday 15th March 2020
Venue: Ding Garden, 2F, Fullon Hotel Linkou, Taoyuan, Taiwan

※ Live Stream on Youtube
Day 1: https://www.youtube.com/watch?v=s3RoX1HEku4
Day 2: https://www.youtube.com/watch?v=nu_F0KI7s7I
Day 3: https://www.youtube.com/watch?v=OJ9XWPRTaDM

※ Website: https://www.dialysisaccesssynergy.com/

※ Contact Person
Peipei Chen
Email: dasy2020.tw@gmail.com
Secretariat of DASy & SoDAS Annual Conference 2020

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Contents

1 Welcome Message

2 About Conference

3 Program

3 Day1 / Friday, 13 th March 2020

4 Day2 / Saturday, 14 th March 2020

6 Day3 / Sunday, 15 th March 2020

8 Organizing Committee and Faculty

16 Chairs / Moderators / Commentators

41 Speakers

54 Abstract / Poster

63 Acknowledgements



WELCOME MESSAGE

First of all, I’d like to extend a warm welcome and ‘thank you’ for your interest in

DASy (Dialysis Access Synergy) 2020. I recognize that your time is valuable and

I’m seriously flattered that you chose to join us for this online event. In

successive to previous DASy meetings, we had recruited many experts from

different specialties to share and discuss on their experience in the care of

dialysis access related problems.

Due to the recently tense situation of Coronavirus epidemic episodes in different

areas, we had to adopt necessary transformation of the conference event. We

had taken advantage of the modern information technology to make DASy2020

possible in a teleconference format. Although the pneumonia epidemic had

prevented the traveling of our faculty and delegates to Taiwan this year, we hope

that the internet technology will make the event as informative and fruitful for all

the cyber participants.

With the strongest backup from SoDAS (Society of Dialysis Access Specialist),

TAVAH (Taiwan Association for Vascular and Access Health) endeavors to send

you only the best content regarding access management in this unprecedented

international online event. Hopefully we are able to provide you with practical

tips you can utilize to improve your future clinical practice. With the constant

effort, all of us may provide better patient care for dialysis access worldwide.

In the meantime, I encourage all of you actively take part in the online events. I’d

love to hear from you about what you’ve heard during DASy 2020, and what

you’re interested in in future events to come. I promise we will try our best to

ponder on your precious feedback and take action in our future events.

Again, I sincerely thank you for your attention to DASy with best regards.

Po Jen Ko MD

Chairman of DASy 2020

1


ABOUT CONFERENCE

Time and Location

Date Friday 13 th March – Sunday 15 th March 2020

Venue

Ding Garden, 2F, Fullon Hotel Linkou

Registration Time 13 th March 1250-1320

14 th March 0745-0815

15 th March 0800-0830

Live Stream

Day 1: https://www.youtube.com/watch?v=s3RoX1HEku4

Day 2: https://www.youtube.com/watch?v=nu_F0KI7s7I

Day 3: https://www.youtube.com/watch?v=OJ9XWPRTaDM

Program at a Glance

Ding Garden

1320–1440 Special session

1450–1620 BD Talks – Experts meet in DASy

Day 1, 13 th March

Ding Garden

Day 2, 14 th March

0815–1000 Right access, for the right patient, at a right time and for a right reason

1000–1015 Tea break

1015–1130 How to prevent AV access failure

1140–1245 BD Lunch symposium

1255–1305 Opening ceremony

1315–1445 Unforgettable nightmare in access procedures and what I learnt from it

1445–1505 Break

1515–1630 Recorded procedures and discussion

1640–1728 Managing failing and thrombosed dialysis access

1800–2100 Faculty dinner & moderator meeting

Ding Garden

0830–0945 Innovation in vascular access

0945–1015 Tea break

1015–1100 PD access session

1110–1200 Nursing in dialysis access

1200–1230 Lunch break

1240–1340 Steal syndrome session

1350–1450 Rare AV access related complications

1450–1510 Break

1520–1620 Central vein obstruction

1620–1630 Closing remarks

2

Day 3, 15 th March


Day1 / Friday, 13 th March 2020

PROGRAM

1320-1440 Special session

Ding Garden Chair Jackie Pei Ho, Po Jen Ko

1320-1335 Patient access maintenance during coronavirus

Yu Zhu Wang

1335-1350 Impact of COVID-19 outbreak on dialysis access management in Wuhan

Fan He

1350-1405 Impact of viral outbreak on dialysis access management in Japan

Remy Li Wei Chen

1405-1415 Impact of viral outbreak on dialysis access management

Chung Cheen Chai

1415-1425 Medical conferences in times of COVID -19

Ngoh Chin Liew

1425-1440 Impact of viral outbreak on dialysis access management: Singapore context

Jackie Pei Ho

1450-1620 BD talks – Experts meet in DASy

Ding Garden Chair Po Jen Ko

Commentator Jia Ning Yue, Jimmy Wei Hwa Tan, John Chien Hwa Chang,

Ming Xi Lu, Panagiotis Kitrou

DCBs in Dysfunctional AV Access: Effectiveness and Safety

Applications of covered stent for Access: When and Where?

Strategy and treatment for Symptomatic Central Venous Stenosis (CVS)

3


Day2 / Saturday, 14 th March 2020

PROGRAM

0815-1000 Right access, for the right patient, at a right time and for a right reason

Ding Garden Chair Jackie Pei Ho, Po Jen Ko

Commentator Edward Choke, Hsu Ting Yen, Vikram Vijayan Sannasi,

Yang Dong Liu

0815-0830 Introduce new 2020 KDOQI guideline for hemodialysis access

Charmaine Lok

0830-0845 KDOQI new guideline question, answer and discussion

Charmaine Lok

0845-0900 The pathway dialysis access specialists had gone through in Japan

Akira Miyata

0900-0915 Functional success of AVF: whole process review

Jackie Pei Ho

0915-0930 How do I practice 4Rs for Taiwanese patients who need dialysis: case-based

discussion

Po Jen Ko

0930-0945 How do I practice 4Rs for Australian patients who need dialysis: case-based

discussion

Jan John Swinnen

0945-1000 How do I practice 4Rs for American patients who need dialysis: case-based

discussion

Ingemar Davidson

1000-1030 Tea break

1015-1130 How to prevent AV access failure

Ding Garden Chair John Chien Hwa Chang

Commentator Chih Chun Yang, Harvinder Raj Singh Sidhu, Ming Xi Lu,

Yin Zuo Liu

1015-1030 My surgical strategy to achieve high AV access success

Alexander Meyer

1030-1045 The surgical procedure to prevent AVF maturation failure

Masaaki Murakami

1045-1100 Transposed Basilic Vein Fistula: Experience with 239 Cases

Benjamin Leong

1100-1115 The risk factors of AV access thrombosis

Shih Ming Huang

1115-1130 Immature fistula maturation-little role for embolization

Scott Trerotola

1140-1245 BD Lunch symposium

Ding Garden Moderator John Chien Hwa Chang, Pei Wang, Po Jen Ko

1140-1210 Maintenance Solutions for Access Patency from Singapore prospective

Tan Ru Yu

1210-1240 Optimal management strategy with covered stent in dysfunctional AV access

Panagiotis Kitrou

1240-1245 Discussion

4


Day2 / Saturday, 14 th March 2020

PROGRAM

1255-1305 Opening ceremony

Ding Garden

1315-1445 Unforgettable nightmare in access procedures and what I learned from it

Ding Garden Chair Akira Miyata, Sung Yu Chu

Commentator Ahmad Rafizi Hariz, Chun Hsien Hsin, Jia Ning Yue,

Sorracha Rookkapan, Teguh Marfen

1315-1330 Rajesh Dharmaraj Babu

1330-1345 Alexander Meyer

1345-1400 Panagiotis Kitrou

1400-1415 Jan John Swinnen

1415-1430 Sung Yu Chu

1430-1445 Ngoh Chin Liew

1445-1505 Break

1515-1630 Recorded procedures and discussion

Ding Garden Chair Alexander Meyer, Ying Cheng Chen

Commentator Edward Choke, Remy Li Wei Chen, Shih Ming Huang,, Yi Ting Tsai

Endo AVF creation

Charmaine Lok

1530-1545 The usefulness of intraoperative blood flow measurement during AVF

creation as a parameter for maturation

Sang Seob Yun

1545-1600 What you don’t know about central venous stenosis

Scott Trerotola

1600-1615 The role of delicated venous stents for central venous obstruction

Tarun Grover

1615-1630 HeRO graft: experience in Chang Gung Hospital

Chun Hsien Hsin

1640-1728 Managing failing and thrombosed dialysis access

Ding Garden Chair Akira Miyata, Jimmy Wei Hwa Tan

Commentator Hong Ye, Hsuan Tzu Yang, Ngoh Chin Liew, Shih Hsien

Weng, Sorracha Rookkapan

1640-1752 The usefulness of ultrasound for vascular access management, and ultrasound

guided intervention therapy for vascular access stenosis and obstruction

Hiroaki Haruguchi

1652-1740 AV access thrombosis treatment with Angiojet

Ta Wei Su

1704-1716 Complications associating with thrombosed AVG salvage, how to prevent them?

Yang Dong Liu

1716-1728 Efficient service program to salvage thrombosed AVG in Thailand

Sorracha Rookkapan

1800-2100 Faculty dinner & moderator meeting

Fullon Hotel Linkou

5


Day3 / Sunday, 15 th March 2020

PROGRAM

0830-0945 Innovation in vascular access

Ding Garden Chair Po Jen Ko, Tarun Grover

Commentator Heng Wan, Lillian Lou Li, Sung How Sue, Sung Yu Chu,

Yang Dong Liu

0830-0845 Portable device for your HD access monitoring

Yu Wei Fang

0845-0900 Report on first clinical trial of using Sirolimus coated balloon for HD access stenosis

Tan Chieh Suai

0900-0915 Application of AI to dialysis and vascular access care

Milind Nikam

0915-0930 Drug Coating Technology in Chronic Hemodialysis Catheters and its

Applications

Chun Hsien Hsin

0930-0945 Effectiveness of combination cutting balloon and drug coated balloon

angioplasty for AVF patency

Tay Kiang Hiong

0945-1015 Tea break

1015-1100 PD access session

Ding Garden Chair Hsuan Jen Lin

Chairman Christopher Leo, Ming Xi Lu

1015-1030 Percutaneous PD Catheter Placement by nephrologist

Hsuan Jen Lin

1030-1045 Prevent Postoperative Complications after Laparosocpic CAPD Catheter

Implantation

Tsann Long Hwang

1045-1100 Treatment of PD infection and complications

Lo Man Wai

1110-1200 Nursing in dialysis access

Ding Garden Chair Jui Hsiang Lin

Commentator Alice Su, Lillian Lou Li, Nai Hua Hsiao, Pei Hsuan Chen

1110-1122 Patient centered dialysis center, what is it?

Lillian Lou Li

1122-1134 The impact of frailty on the outcomes of hemodialysis vascular accesses

Chiu Hui Chen

1134-1146 The effectiveness of physical examination for vascular access in hemodialysis

room in Chi Mei Hospital, Chiali, Taiwan

Li Hwa Tsai

1146-1158 The experience of establishing safety culture for dialysis access care in Taiwan

Tiffany Chang

1158-1200 New patient education model in PD of National Taiwan University Hospital

Yu Jun Zhan

1200-1230 Lunch break

6


Day3 / Sunday, 15th March 2020

PROGRAM

1240-1340 Steal syndrome session

Ding Garden Chair Chung Dann Kan

Commentator Hsu Ting Yen, Jimmy Wei Hwa Tan, Masaaki Murakami,

Vikram Vijayan Sannasi

1240-1255 Understanding Steal Syndrome: Causes and Prevention

Sung How Sue

1255-1310 Steal syndrome—strategies to preserve both the vascular access and the

extremity

Zheng Ya Yu

1310-1325 Surgical correction of Dialysis Access Steal Syndrome

Hiroaki Haruguchi

1325-1340 Endovascular correction of Dialysis Access Steal Syndrome

Veera Suwanruangsri

1350-1450 Rare AV access related complications

Ding Garden Chair Hsu Ting Yen, Jan John Swinnen

Commentator Benjamin Leong, Chih Chun Yang, Sang Seob Yun, Tan

Chieh Suai, Veera Suwanruangsri, Ying Cheng Chen

1350-1405 Increased mortality rates after DCB for PAD patients: Is it real and does it

affects hemodialysis patients?

Jan John Swinnen

1405-1420 A provider-initiated patient tracking systems by using A Web-Based Platform

in a vascular access referral center in China

Jia Ning Yue

1430-1445 Arm pain during hemodialysis: shunt related?

Remy Li Wei Chen

1445-1500 Rare hemodialysis catheter-related complications

Hong Ye

1450-1510 Break

1520-1620 Central vein obstruction

Ding Garden Chair Jackie Pei Ho, John Chien Hwa Chang

Commentator Ahmad Rafizi Hariz, Edward Choke, Yin Zuo Liu

1520-1535 Operation techniques and single-center follow-up result of chest wall

arteriovenous graft

Kang She

1535-1550 HeRO graft Taiwan experience

Shih Hsien Weng

1550-1605 Central vein intervention: perspectives from nephrologist

Yu Fei Wang

1605-1620 Resurrection of bare metal stent in treatment of CVS

Jimmy Wei Hwa Tan

1620-1630 Closing remarks

Ding Garden

7


Director

Chairman

Jackie Pei Ho

Singapore

Po Jen Ko

Taiwan

Organizing Committee

John Chien Hwa Chang

Taiwan

Jimmy Wei Hwa Tan

Taiwan

Ming Ju Hsieh

Taiwan

Pei Hsuan Chen

Taiwan

Shih Hsien Weng

Taiwan

Sung Yu Chu

Taiwan

8


Faculty

Ahmad Rafizi Hariz

Malaysia

Akira Miyata

Japan

Alexander Meyer

Germany

Alice Su

Taiwan

Benjamin Leong

Malaysia

Charmaine Lok

Canada

Chih Chun Yang

Taiwan

Chiu Hui Chen

Taiwan

Christopher Leo

Singapore

9


Faculty

Chun Hsien Hsin

Taiwan

Chung Cheen Chai

Singapore

Chung Dann Kan

Taiwan

Edward Choke

Singapore

Fang He

China

Harvinder Raj Singh Sidhu

Singapore

Heng Wan

China

Hiroaki Haruguchi

Japan

Hong Ye

China

10


Faculty

Hsu Ting Yen

Taiwan

Hsuan Jen Lin

Taiwan

Hsuan Tzu Yang

Taiwan

Ingemar Davidson

US

Jan John Swinnen

Australia

Jia Ning Yue

China

Jui Hsiang Lin

Taiwan

Kang She

China

Li Hwa Tsai

Taiwan

11


Faculty

Lilian Lou Li

Singapore

Lo Man Wai

Hong Kong

Masaaki Murakami

Japan

Milind Nikam

Singapore

Ming Xi Lu

China

Nai Hua Hsiao

Taiwan

Ngoh Chin Liew

Malaysia

Panagiotis Kitrou

Greece

Pei Wang

China

12


Faculty

Rajesh Dharmaraj Babu

Singapore

Remy Li Wei Chen

Japan

Sang Seob Yun

Korea

Scott Trerotola

US

Shih Ming Huang

Taiwan

Sorracha Rookkapan

Thailand

Sung How Sue

Taiwan

Ta Wei Su

Taiwan

Tan Chieh Suai

Singapore

13


Faculty

Tan Ru Yu

Singapore

Tarun Grover

India

Tay Kiang Hiong

Singapore

Teguh Marfen

Indonesia

Tiffany Chang

Taiwan

Tsann Long Hwang

Taiwan

Veera Suwanruangsri

Thailand

Vikram Vijayan Sannasi

Singapore

Yang Dong Liu

China

14


Faculty

Yi Ting Tsai

Taiwan

Yin Zuo Liu

Taiwan

Ying Cheng Chen

Taiwan

Yu Fei Wang

China

Yu Zhu Wang

China

Yu Jun Zhan

Taiwan

Yu Wei Fang

Taiwan

Zheng Ya Yu

China

15


Chairs /

Moderators /

Commentators

Listed in alphabetical order of first name

16


Ahmad Rafizi Hariz

Medical Lecturer, Department of Surgery, Faculty of

Medicine, University of Malaya

Areas of Research

• 2019 – 2021 Far Infrared Therapy In Promoting Early Arteriovenous

Fistula Maturation, Co-Investigator, Private Funding, (National)

• 2019 – 2021 Salvage VS Amputate : A Mixed Cohort Review based

on WIfI Classification in Asian Population, Co-Investigator, NONE, (National)

• 2018 – 2019 Modified MALAYA technique for Endoleak Prophylaxis

in EVAR, Principal Investigator(PI), NONE, (National)

• 2017 – 2019 MALAYA technique for treatment of peripheral arterial

pseudoaneurysm, Principal Investigator(PI), NONE, (National)

Akira Miyata

Head, Clinical Department, International Medical Relief of

Kumamoto Red Cross Hospital, Kumamoto, Japan

Dr. Miyata has varies international disaster response experience. He was the

team leader of Japanese Red Cross-Emergency Response Unit for South-East

Iran earthquake in 2004, South Asia earthquake in 2005 and Chile earthquake in

2010. He also served as the team leader of Hong-Kong red cross / Japanese red

cross joint training course for the Emergency Response Unit of International Red

Cross and Red Crescent Societies in Hong Kong in 2010. Currently, He is

working as the Japanese Representative of the Asia-Pacific Medico-Legal

Association Networks for the Victims of Disasters and Terrorism.

17


Alexander Meyer

Senior Consultant, Department of General, Visceral,

Vascular Surgery and Coloproctology, Johanniter

Krankenhauses Rheinhausen

Experience

• 1999 – 2005 Chief Consultant at the Department of General, Visceral

and Vascular Surgery, Katholische Kliniken Essen-Nord-West

• 1996 – 1999 Consultant at the Department of General, Visceral and

Vascular Surgery, Katholische Kliniken Essen-Nord

• 1992 – 1995 Registrar and Senior Registrar at the Department of

General, Abdominal, Vascular and Pediatric Surgery (Prof. Dr. Feifel) and

at the Department of Traumatology (Prof. Dr. Mutschler), University Hospital

Homburg / Saar

• 1991 – 1992 Senior House Officer at the Department of General and

Abdominal Surgery, Städtisches Klinikum Fulda (Prof.Dr. K.-D. Rumpf)

Alice Su

Clinical Service Specialist, DaVita Care (Taiwan)

Private Limited

Experience

• 2016 – 2016 Deputy Head Nurse, An Ren Clinic

• 1994 – 2016 Head Nurse, Three Trust Clinic

• 1988 – 1994 Hemodialysis Nurse Leader, Chung Gung Memorial

Hospital

• 1988 – 1988 Nurse, Taipei Blood Center

18


Benjamin Leong

Consultant Vascular & Endovascular Surgeon, KPJ

Sabah Specialist Hospital, Sabah, Malaysia

Experience

• Special interest in vascular access and endovascular interventions

• Qualified as vascular surgeon in 2013 with training from Kuala Lumpur

Hospital and Royal Perth Hospital

• Set up and initiated permanent vascular surgical service in Sabah, East

Malaysia and current head of vascular surgical service in Sabah

• Course director in aortic, venous and peripheral endovascular workshops.

• Invited faculty for both local and international vascular conferences

Chih Chun Yang

Chief Director, Da Chien Health Medical System,

Department of Cardiovascular Surgery

Experience

• 2016 – 2019 Attending Medical Doctor, Tainan Municipal An-Nan

Hospital - China Medical University, Department of Cardiovascular Surgery

• 2014 – 2016 Attending Medical Doctor, Taichung Veterans General

Hospital, Chiayi branch, Department of Cardiovascular Surgery

• 2010 – 2013 Residency, cardiovascular surgery, Taichung Veterans

General Hospital, Department of Cardiovascular Surgery

• 2009 – 2010 Residency, cardiovascular surgery, Taipei Veterans General

Hospital, Department of Cardiovascular Surgery

19


Christopher Leo

Consultant, Nephrology, National University Health

System

Dr. Christopher Leo graduated from the Auckland University School of Medicine,

New Zealand. He is a Consultant Nephrologist and is a Fellow of the Academy

of Medicine (Singapore) and the Royal College of Physicians (Edinburgh). His

interest lies in dialysis access namely endovascular interventions of

haemodialysis fistulae and grafts, ultrasound assessments of vascular accesses,

peritoneal dialysis and vascular dialysis catheter procedures. He worked closely

with Dr. Jan (John) Swinnen from Westmead Hospital in Sydney (Australia) to

acquire the necessary endovascular and clinical skills to manage arteriovenous

dialysis accesses.

Chung Dann Kan

Professor, Department of Surgery, National Cheng

Kung University Hospital

Experience

• 2013 – 2018 Associate Professor, Department of Surgery, National

Cheng-Kung University Hospital

Specialties

• Cardiovascular Surgery, Cell Regeneration, Aortic stent surgery,

Bioengineering

Education

• Ph. D. Institute of Clinical Medicine, Medical College, National Cheng-Kung

University

• Doctor of Medicine, Kaohsiung Medical College, Kaohsiung, Taiwan

20


Chun Hsien Hsin

Attending Doctor, Department. of Vascular Surgery,

Chang Gung Memorial Hospital, Linkou Medical

Center

Experience

• 2013 – 2016 Fellowship of Dept. of Thoracic & Cardiovascular

Surgery, Chang Gung Memorial Hospital, Linkou medical center, Taoyuan,

Taiwan

• 2011 – 2013 Residency of Dept. of Surgery, Chang Gung Memorial

Hospital, Linkou medical center, Taoyuan, Taiwan

• 2009 – 2010 Internship of National Taiwan University Hospital, Taipei,

Taiwan

Edward Choke

Consultant Vascular and Endovascular Surgeon,

Sengkang General Hospital and Singapore General

Hospital

Dr. Edward Choke is presently a Consultant Vascular and Endovascular Surgeon

at Sengkang General Hospital and Singapore General Hospital. He graduated

with first class honours MBBS from the University of Sydney and undertook

specialist training in General and Vascular Surgery in Oxford between 2006 and

2010. In 2010 he was appointed the Clinical Lecturer/Specialist Registrar at the

vascular unit in Leicester Royal Infirmary. He received training in complex

tertiary level vascular and endovascular surgery, including complex abdominal

and thoracic aortic aneurysm repairs (open, endovascular or hybrid techniques)

and complex carotid surgery.

21


Harvinder Raj Singh Sidhu

Senior Consultant, General Surgery, Ng Teng Fong

General Hospital

Experienced in both Open and endovascular surgery. Underwent vascular

training in Singapore, New Zealand and Australia. Graduated from the Royal

College of Surgeons in Ireland in 1997.

I have been trained in both vascular and endovascular surgery. Other than my

formal training, I completed a short stint in Leipzig, Germany in 2013 in

endovascular surgery. I can perform highly complex endovascular hybrid

procedures, which include aortic and peripheral arterial work. I am also

competent in endovenous ablation therapy for varicose veins. My specialty

interest is in diabetic foot limb salvage and I am very active in renal access

surgery for patients on dialysis.

Heng Wan

Department of vascular surgery, Nanfang Hospital,

Southern Medical University

Experience

• Young member of the branch of foreign science of Guangdong Medical

Association

• Member and Secretary of hemodialysis pathway group, foreign science

branch, Guangdong Medical Association

• Expert of vascular pathway group of the second blood purification center

management committee of Guangdong Hospital Association

22


Hong Ye

Chief, Center for Blood Purification, The Second

Affiliated Hospital of Nanjing Medical University

Experience

• Deputy Chief, Center for Renal Disease, The Second Affiliated Hospital of

Nanjing Medical University

• Committee, Chinese Society Of Blood Purification Administration

• Chinese Medical Doctor Association

• Committee, China International Exchange and Promotion Association for

Medical and Healthcare

Hsuan Jen Lin

Attending Physician, Nephrology Department, Asian

University Hospital

Education

• Graduated from the School of Medicine, China Medical University

Specialties

• Electrolyte imbalance

• Chronic renal disease control

• Hemodialysis for uremia patients

23


Hsuan Tzu Yang

Fellowship, Cardiovascular Surgical Department,

Chang Gung Memorial Hospital, Taoyuan

Experience

• 2012 – 2014 Surgical Resident, Chang Gung Memorial Hospital

(CGMH), Taoyuan

• 2011 – 2012 Post Graduate Year, Chi Mei Hospital, Tainan

• 2010 – 2011 Internship of Traditional Chinese Medicine Department,

CGMH, Taoyuan

• 2009 – 2010 Internship, Chang Gung Memorial Hospital, Taoyuan

Hsu Ting Yen

Attending Physician, Division of Cardiovascular

Surgery, Chang Gung Memorial Hospital Kaohsiung

Medical Center

Experience

• 2005 – present Visiting staff, Department of Thoracic Cardiovascular

Surgery, Chang-Gung Memorial Hospital, Kaohsiung Medical Center,

Taiwan

• 2003 – 2005 Fellowship, Department of Thoracic Cardiovascular

Surgery, Chang-Gung Memorial Hospital, Kaohsiung Medical Center,

Taiwan

Education

• Kaohsiung Medical University

24


Jackie Pei Ho

Founding President of Society of Dialysis Access

Specialists SoDAS

Senior Consultant, Department of Cardiac, Thoracic

and Vascular Surgery, National University Health

System

Experience / Specialist

• 2013 – present Associate Professor (tenure), Department of Surgery,

National University of Singapore

• 2008 – present Department of Cardiac, Thoracic and Vascular Surgery,

National University Hospital

• 2008 – 2013 Assistant Professor, Department of Surgery, National

University of Singapore

Jan John Swinnen

Clinical Associate Professor, Westmead Hospital,

Australia

For 45 years, internationally respected vascular surgeon, Dr. John Swinnen, has

used his extensive skills, experience and compassion to save and better the lives

of thousands. Part of humanitarian organisation Médecins Sans Frontières /

Doctors Without Borders (MSF) since 2011, John has risked his life in some of

the world's most dangerous zones, including Eastern Congo, the

Afghanistan-Pakistan border, Yemen and Gaza.

He has performed a staggering 1,232 operations, treating more than 350

gunshot wounds, 250 bomb blast injuries, and five mass-casualty situations–

including the 2015 Houthi Siege in Yemen which saw 206 critical patients

treated by the service in six hours.

25


Jia Ning Yue

Attending Surgeon, Vascular Department in Zhongshan

Hospital Fudan University

Experience

• 2011 – 2013 Clinical fellowship, Vascular Department in Zhongshan

Hospital Fudan University

• 2009 – 2011 Research fellowship, Saint Joseph’s Translational

Research Institute, GA, USA

• 2004 – 2009 Residency on call for surgical service, Zhongshan

Hospital and Shanghai Xinhua Hospital

Jimmy, Wei Hwa Tan

Director, Surgery Department, Tainan Municipal

An-Nan Hospital, China Medical University

Experience

• 2013 – present Chief, Cardiovascular Surgery Department, Tainan

Municipal An-Nan Hospital, China Medical University and China Medical

University Beigang Hospital

• 2007 – 2013 Chief, Cardiovascular Surgery Department, Dalin

Tzu-Chi General Hospital

Specialties

• OPCAB and total artery OPCAB

• Mitral valvuloplasty

• Endovascular surgery (AV access, carotid, Venous)

26


John, Chien Hwa Chang

Director, Cardiovascular Surgery, Dalin Tzuchi General

Hospital

Experience

• 2010 – 2011 Fellowship, Angiology, Leipzig Heart Center, Leipzig,

Germany

• 2010 – 2013 Chief, Vascular Surgery, Dalin Tzuchi General Hospital,

Chiayi county, Taiwan, R.O.C.

• 2008 – 2010 Visiting Staff, Cardiac Surgery, Dalin Tzuchi general

hospital, Chiayi county, Taiwan, R.O.C.

• 2007 – 2008 Chief resident, cardiovascular surgery, National Taiwan

University Hospital, Taipei, Taiwan, R.O.C.

Jui Hsiang Lin

Nephrologist, De-Ren General Hospital

Jui Hsiang Lin is a nephrologist in De-Ren General Hospital and focus on

dialysis, renal care, plasma exchange, plasmapheresis, and secondary hypertension.

He has been practiced for more than 10 years. He passed United States medical

license examination and Taiwan medical license board exam. Many articles

have been published. He is also an instructor in medical college of National

Yang-Ming University. He won the prize for the outstanding university faculty,

scholarship program, graduate institute of clinical medicine of Taipei Medical

University, and a lot of travel grants in international meetings.

27


Lillian Lou Li

Chief Operating Officer, TAL Dialysis Centre

Lillian has 20 years of extensive experience in dialysis nursing, clinical training

and management of dialysis centre. Her strong dialysis knowledge ranges from

chronic outpatient dialysis, such as hemodialysis (HD) and peritoneal dialysis

(PD), as well as acute dialysis (CRRT, MARS, TPE) and home dialysis. In

addition to her ongoing work in the role of Mentor and Dialysis Centre Manager,

she has been involved in outpatient new dialysis centers setup, hospital based

joint venture projects and management-contract based project with Singapore

dialysis institution. Lillian believes in developing clinical leadership to improve

dialysis quality, outcomes and patient satisfaction.

Masaaki Murakami

Director, Vascular Access Center, Shizuoka General

Hospital

Experience

• 2010 – present Deputy Head, Physician, Shizuoka General Hospital

• 2005 – 2010 Resident, Shizuoka General Hospital

• 2004 – 2005 Clinical Fellow, Shizuoka General Hospital (Supervisor,

Noriko Mori, M.D.)

• 2003 – 2004 Clinical Fellow, Tokushima University (Supervisor,

Toshio Doi, M.D.)

Specialties

• Brachial artery superficialization

• Appropriate vascular access creation

28


Ming Xi Lu

Deputy Chief Physician, Department of Nephrology,

Sir Run Run Shaw Hospital Zhejiang University

School of Medicine

Experience

• 2002 – present Deputy Chief Physician, Department of Nephrology, Sir

Run Run Shaw Hospital Zhejiang University School of Medicine

Education

• 1997 – 2002 Clinical Medical, Zhejiang University School of Medicine

Nai Hua Hsiao

Nursing Department, Dalin Tzu Chi Hospital

My name is Hsiao, Nai-Hua. I am mainly engaged in the case follow and

management of A-V access, data statistics, A-V access care education for

patients, diet health care, and health education.

I hold a bachelor’s degree with a major in Nursing which was awarded to me by

Chung Hwa University of Medical Technology in Tainan in 2014.

Besides my major, I have also taken many course related to nursing care

science like Long term care program, nursing case management, nursing study

and evidence-based nursing, which have prepared me for software

programming in the field of nurse and study.

29


Ngoh Chin Liew

Consultant, Vascular Surgery, Subang Medical Center

Dr. Liew Ngoh Chin is one of the most renowned Vascular Surgery in practicing

at Subang Jaya Medical Centre of successful surgeries and his expertise lies in

the field of Vascular Surgery. Dr. Liew Ngoh Chin has achieved several

recognitions such as Vascular Surgery.

Procedure Focus

• Arteriovenous FIstula

• General surgery

• Laser Vein Surgery

• Vascular surgery

Panagiotis Kitrou

Consultant, Interventional Radiologist, Patras University

Hospital, Athens, Greece

Dr. Panagiotis M. Kitrou MD, MSc, PhD, EBIR is a Consultant Interventional

Radiologist in Patras University Hospital, Greece. His main scientific interests

are Dialysis, Peripheral Arterial Disease and Interventional Oncology. He has

published more than 40 scientific papers in peer review journal and has been

nominated the Editor’s Award for Distinguished Clinical Study in Vascular and

Interventional Radiology by JVIR in 2015 and 2017. He is a reviewer for more

than 10 peer review journals and has been a Distinguished Reviewer for Cardio

Vascular and Interventional Radiology (CVIR) in 2017. He has more than 200

lectures and presentations in international scientific meetings, symposia and

congresses around the world.

30


Pei Hsuan Chen

Head Nurse, Sixin Clinic Hemodialysis Room and

Clinical Operation Specialist

Experience

• 2020 – present Vitech Health Care Co. Nurse Director

• 2019 – present General Secretary of Taiwan Association of Vascular

and Access Health

• 2017 – 2019 Supervision and Operation Specialist, Davita Taiwan

• 2009 – 2016 Head Nurse, Anshiu clinic Davita Taiwan Hemodialysis

Room

• 2008 – 2009 Head Nurse, Ton-shiun clinic Hemodialysis Room

Pei Wang

Director, Blood Purification Center, the First Affiliated

Hospital of Zhengzhou University

Experience

• Director of Blood Purification Center of the First Affiliated Hospital of

Zhengzhou University

• Vice Director of Nephrology Institute of Zhengzhou University

• Henan Province Outstanding Youth Science and Technology Expert

• Vice president of Youth Committee of Chinese Society of Nephrology

Education

• Major in the clinical and basic research of blood purification and Vascular

Access

31


Po Jen Ko

Chairman, Taiwan Association of Vascular and

Access Health, Taiwan

Experience

• 2005 – present Assistant Professor, Vascular Surgery, Chang Gung

Memorial Hospital (CGMH), Taipei

• 2006 – present Assistant Professor, Chang Gung University

• 1994 – 1997 R1~R3 Department of Surgery, CGMH Taipei

• 1997 – 1999 Fellow, Division of Toracic & Cardiovascular Surgery,

CGMH

• 1999 – 2003 Attending staff, Section of Cardiovascular Surgery,

GCMH

Remy Li Wei Chen

Visiting Staff, Dialysis Center, Kamifukuoka General

Hospital

Experience

• 2018 – present Freelance Nephrologist (VS)

• 2016 – 2018 Chief, Hasuda Hospital, Kidney Dialysis Center

• 2014 – 2016 Deputy Director, Tokyo Next Dialysis Clinic

• 2012 – 2014 Chief, Nishi Tokyo Central Hospital, Nephrology and

Dialysis Department

• 2011 – 2012 Chief, Koganei Taiyo Hospital, Dialysis Department

• 2010 – 2011 Chief, Ageo Central Hospital, Division of Nephrology

• 2009 – 2010 Chief, Tsukuba Central Hospital, Division of Nephrology

32


Sang Seob Yun

Chief Professor, Aorto-Peripheral Vascular Center,

Seoul St. Mary's Hospital

Experience

• 2017 – 2019 Chief Professor, Cardio-Cerebro-Vascular Center, Seoul

St. Mary's Hospital

• 2016 – 2019 Chief Professor, Department of general surgery, Seoul

St. Mary's Hospital

• 2005 – 2016 Chief Director, peripheral vascular center, St Paul’s

Hospital

• 2005 – 2016 Professor, General Surgery, St Paul’s Hospital

Shih Hsien Weng

Attending Surgeon, Cardiovascular Surgery,

Landseed International Hospital

Experience

• 2012 – 2014 Attending Surgeon, Cardiovascular Surgery, Taipei

Veterans General Hospital, Taoyuan branch

• 2007 – 2013 Resident, Cardiovascular Surgery, Taipei Veterans

General Hospital

Education

• School of Medicine, China Medical University

Specialties

• Adult Cardiac Surgery

• Aortic Surgery

33


Shih Ming Huang

Attending Surgeon, Cardiovascular Surgery

Department, Dalin Tzu Chi Hospital, Buddhist Tzu

Chi Medical Foundation

Experience

• 2014 – 2014 Fellowship of Cardiovascular surgery, National Taiwan

University Hospital

• 2011 – 2014 Resident in Cardiovascular surgery, National Taiwan

University Hospital

• 2009 – 2011 Resident in Cardiovascular surgery, National Taiwan

University Hospital

• 2008 – 2008 Resident in Emergent department, Buddhist Tzu Chi

General Hospital

Sorracha Rookkapan

Clinical Instructor, Division of Body and Vascular

Interventional Radiology, Prince of Songkla University,

Hatyai

Dr. Sorracha Rookkapan, an interventional radiologist at Prince of Songkla

University, Hatyai, Songkhla, Thailand.

I finished the IR fellowship training program from Prince of Songkla University

and short course visiting fellow at Park Hospital, Leipzig, Germany

My specialty is about endovascular treatment for vascular disease including

PAD and malfunction hemodialysis access and now I work at the vascular

excellence center at Songklanagarind hospital, Prince of Songkla University

34


Sung How Sue

Chief, Department of Cardiovascular Surgery, Pojen

General Hospital

Experience

• Surgeon, Department of Surgery, Cheng Hsin General Hospital

• Lecturer, Department of Surgery, Tri-Service General Hospital

Publications

• Real-Time 3-Dimensional Transesophageal Echocardiography in the

Evaluation of Mitral and Aortic Valve Prosthetic Valve Dehiscence

• Risk Factors and Surgical Prognosis in Patients with Infra-Renal Abdominal

Aortic Aneurysms

• Clinical Application of Intraoperative Real-Time Three-Dimensional

Transesophageal Echocardiography

Sung Yu Chu

Assistant Professor, Department of Medical Imaging

and Intervention, Chang Gung Memorial Hospital

Experience

• 2012 – 2019 Lecturer, Chang Gung Memorial Hospital (CGMH),

Linkou

• 2003 – present Visiting Staff, Department of Medical Imaging and

Intervention, CGMH, Linkou

• 1999 – 2003 Residency in Department of Radiology, CGMH

35


Tan Chieh Suai

Senior Consultant, Department of Renal Medicine,

Singapore General Hospital, Singapore

Dr. Tan Chieh Suai is a senior consultant at the Department of Renal Medicine,

Singapore General Hospital. He is also a Clinical Senior Lecturer at the National

University of Singapore Yong Loo Lin School of Medicine and an adjunct

Assistant Professor at the Duke-NUS Medical School. His interest is focused on

Interventional Nephrology. On the average, the interventional suite performed

approximately 900 dialysis access related procedure each year, including

thrombolysis, angioplasty, stenting and tunneled hemodialysis catheter

procedures.

Tarun Grover

Director and In-charge Peripheral Vascular Lab,

Division of Vascular and Endovascular sciences,

Medanta - the Medicity

After being bestowed the honour of “First fellow in vascular and Endovascular

surgery” in 2003 accredited by the National Board of Examinations, Ministry of

Health and Family Welfare, Govt. of India, Dr. Tarun Grover embarked upon his

career as a fully trained Vascular & Endovascular surgeon at a busy tertiary

referral care centre in the very heart of Delhi city where he practiced for 16

years.

Currently he is the Associate Director and in-charge Peripheral vascular Lab,

The Division of Vascular & Endovascular sciences, at one of the premier Health

care institute in India- Medanta - The Medicity. His experience as a Vascular &

endovascular specialist spans for almost over 20 years now.

36


Teguh Marfen

Assistant Professor (Lektor), Surgery, Department of

Surgery, Faculty of Medicine, Universitas Padjadjaran

Experience

• 2006 – 2009 General surgeon in Cahya Kawaluyan Hospital

• 2000 – 2000 Services as Government medical doctor, as head of

primary health care in Bojong, Purwakarta, West Java

• 1999 – 1999 Services as Government medical doctor in Dili Hospital,

East Timor

Veera Suwanruangsri

Department of Surgery, Vascular and Endovascular

Unit, Maharat Nakhon Ratchasima Hospital

Experience

• 1997 – 2000 Resident Training Program of General Surgery at

Ramathibodi Hospital

• 2000 – present Practice in Department of Surgery, Maharat Nakhon

Ratchasima Hospital

• Perform a variety of operations of benign and malignant disease

• Perform open repair of AAA (>100 cases), bypass operations for PAD (>100

cases) and vascular access operations (>4,000 cases)

• Perform >300 cases of EVAR in seven years

• Perform >1,000 cases of peripheral intervention in eight years

37


Vikram Vijayan Sannasi

Senior Consultant Surgeon, Department of General

Surgery, Ng Teng Fong General Hospital

Having successfully completed the FRCS exit examinations in 2009, Adj Asst

Prof Vijayan was awarded the Certificate of Completion of Training. As part of

his post-exam fellowship year, he joined the Department of Vascular Surgery at

the Royal Perth Hospital in Western Australia, and focused on complex

endovascular and open vascular surgical management. He was exposed to a

substantial amount of vascular trauma–the result of a stint with the Western

Australian State Trauma Unit. Adj Asst Prof Vijayan is an active member of

several committees in JurongHealth, including the Patient Safety Workgroup, the

Diabetic Foot Workgroup, the Mortality & Morbidity Quality Assurance

Committee.

Yang Dong Liu

Associate Professor, Department of Vascular

Surgery, the First Affiliated Hospital, Chongqing Medical

University, China

Experience

• Vice-Chairman of the Chinese Medical Doctor Association hemodialysis

access Committee

• Vice-Chairman of the China non-public medical structure association kidney

disease dialysis Specialized Committee hemodialysis access Committee

• Vice-Chairman of the Chinese Association of Integrative Medicine Peripheral

Vascular Diseases Committee

38


Yi Ting Tsai

Chief, Division of Cardiovascular Surgery, Tri-Service

General Hospital

Experience

• 2003 – present Attending Physician, Division of Cardiovascular Surgery,

Department of Surgery, Tri-Service General Hospital

• 2016 – present Chief, Division of Cardiovascular Surgery, Tri-Service

General Hospital

• 2016 – present Associate Professor, Medicine National Defense

Medical Center, Taipei, R.O.C

Yin Zuo Liu

Chief, Cardiovascular Surgery Department, Asia

University Hospital

Experience

• 2014 – 2016 Chief of Cardiovascular Surgeon Department, Taichung

Hospital, Ministry of Health and Welfare, Taiwan

• 2010 – 2014 Cardiovascular Surgeon, Taichung Hospital, Ministry of

Health and Welfare, Taiwan

• 2009 – 2010 Cardiovascular Surgery Residency, Cheng Hsin Hospital,

Taiwan

• 2008 – 2009 Cardiovascular Surgery Residency, Kaohsiung Medical

University Hospital, Taiwan

39


Ying Cheng Chen

Chief, Department of Cardiovascular, Changhua

Christian Hospital

Experience

• Residency in Department of Surgery, National Taiwan University Hospital

• Attending Physician, Division of Cardiovascular Surgery, National Taiwan

University Hospital

Education

• School of Medicine, China Medical University

Specialties

• Da Vinci Surgical System

• Aortic Stent Graft

40


SPEAKERS

Listed in alphabetical order of first name


Charmaine Lok

Senior Scientist, Toronto General Hospital Research

Institute

Charmaine Lok is a Professor of Medicine at the Faculty of Medicine, University

of Toronto and Senior Scientist at the Toronto General Hospital Research

Institute. She is also associated with the Department of Clinical Epidemiology

and Biostatistics, Faculty of Health Sciences, McMaster University.

Research Interests

Dr. Lok is the Medical Director of both the Chronic Kidney Diseases and

Hemodialysis Vascular Access Programs at the Toronto General Hospital.

Chiu Hui Chen

Clinical Nursing Preceptor, Dialysis Center, National

Taiwan University Hospital Hsinchu Branch

Experience

• 2019 – present Director, Taiwan Nephrology Nurses Association TNNA

• 2007 – 2013 Head Nurse, Dialysis Center, National Taiwan

University Hospital Hsin-Chu Branch

• 1994 – 1999 Clinical Nursing Preceptor, Dialysis Center, Lo-Hsu

Medical Foundation Lotung Poh-Ai Hospital

• 1991 – 1993 Nurse, Surgical intensive care unit, Chang Gung

Memorial Hospital, Linkou

42


Chung Cheen Chai

Nephrologist, Division of Nephrology, Department of

Medicine, Khoo Teck Puat Hospital

I am Nephrologist in Division of Nephrology, Department of Medicine at Khoo

Teck Puat Hospital (KTPH), National Healthcare Group, Singapore. My area of

sub-specialty interest is in Interventional Nephrology. There is Visiting

Interventional Nephrologist in KTPH, and I learnt techniques and skills to

contribute to this hospital. I did my Fellowship training in advanced vascular

access management in Division of Vascular Surgery, Linkou Chang-Gung

Memorial Hospital, Taiwan.

Fan He

Associate Professor and Vice Director, Division of

Nephrology, Department of Internal Medicine, Tongji

Hospital

Experience

• 2014 – present Associate Professor and Vice Director of Division of

Nephrology, Tongji Hospital

• 2012 – 2014 Attending doctor in division of nephrology, Tongji Hospital

Research Area

CVD Complications of CKD, Hemodialysis Vascular Access.

Research Program

• The mechanism of USP20 regulated macrophage glucose metabolism and

following inflammatory storm in crescentic glomerulonephritis

43


Hiroaki Haruguchi

Director, Haruguchi Vascular Access Clinic

In our hospital, we will not only make the first shunt, but also treat and treat

various shunt troubles. Patients who have a shunt obstruction are very anxious

about whether or not the next dialysis can be performed, but our hospital will

respond well to such urgent patients. As a treatment method, we are equipped

with facilities to allow both surgery and percutaneous angioplasty with a balloon

catheter, and we will select the treatment suitable for each individual patient. In

addition, although it is basically a day-trip operation, we have partnered with

several hospitals so that patients who need hospitalization after surgery can

receive treatment with peace of mind.

Ingemar Davidson

Professor of Surgery, Division of Surgical Transplantation,

Dallas

Ingemar J.A. Davidson’s professional focus is on organ transplantation, Dialysis

Vascular Access in End Stage Renal Disease patients. He is past Professor of

Surgery, at the University of Texas Southwestern Medical Center Dallas, TX and

Medical Director Parkland’s Vascular Access Clinic. He is also the founder of

Kidney Academy, a non-profit entity dedicated to delivering quality education to

a global audience on topics related to dialysis access.

Dr. Davidson’s research and experience are reflected in books, peer reviewed

publications and proceedings. He is a current or past Reviewer for: Critical Care

Medicine, Journal for the American Society of Nephrology, Clinical Transplantation,

Kidney International, and Juvenile Diabetes Foundation-International.

44


Kang She

Peking University First Hospital

Dr. She obtained the doctor's degree of surgery from the department of

medicine of Peking University in 2015 and worked till now. Dr. She specializes in

vascular open surgery, such as surgery for hemodialysis access, varicose veins,

peripheral vascular disease, abdominal aortic aneurysm, etc.

Dr. She is particularly good at building complex arteriovenous fistula or graft for

patients with poor vessels condition. And Dr. She also has rich experience in the

management of complications of different hemodialysis accesses.

Dr. She has published many papers and obtained several national patents on

peripheral vascular disease and dialysis access.

Li Hwa Tsai

Leader, Hemodialysis Room, Chi Mei Hospital

Experience

• 2006 – 2008 Helin Clinic Hemodialysis

• 2003 – 2008 Madou Sin-Lau Hospital

• 1996 – 2006 Madou Sin-Lau Hospital

Education

• Master of Science in Nursing, Chang Gung University of Science and

Technology

• Bachelor of Science in Nursing, Hongguang Institute of Technology

45


Lo Man Wai

Associate Consultant, Department of Medicine and

Geriatrics, Kwong Wah Hospital

Experience

• 2013 – present Honorary Vascular Trainee in Department of Surgery,

Westmead Hospital, Sydney, Australia for 3 months

• 2008 – 2012 Resident Specialist in Department of Medicine and

Geriatrics in Kwong Wah Hospital and Our Lady of Maryknoll Hospital

• 2003 – 2008 Resident in Department of Medicine and Geriatrics of

Kwong Wah Hospital in higher physician training in Advanced Internal

Medicine and Nephrology. Had rotation to Intensive Care Unit and

convalescence care during training

Milind Nikam

Medical Director, Fresenius Medical Care Visiting

Consultant Interventional Nephrologist, Khoo Teck

Puat Hospital

Dr. Nikam is Senior Medical Director for FMC covering the South East Asia

region. FMC is the largest provider of dialysis services and products in

Singapore and globally.He is also a practicing interventional and general

nephrologist. He graduated in Mumbai with distinctions and a prestigious gold

medal. He then moved to the UK for training in general medicine and nephrology

(mainly in Manchester). He obtained a higher research degree (MD) from Univ.

of Manchester in dialysis vascular access, whilst also training in interventional

nephrology. He subsequently moved to Singapore and set up the advanced

vascular interventional nephrology program in the KTPH.

46


Ming Ju Hsieh

Associate Professor, Division of Thoracic and

Cardiovascular Surgery, Chang Gung Memorial

Hospital

Experience

• 2011 – present Physician Educator, Chang Gung Memorial Hospital

(CGMH)

• 2010 – present Assistant Professor, Surgery, Chang Gung University

• 2009 – present Assistant Professor, Division of Thoracic &

Cardiovascular Surgery, CGMH

• 2002 – 2004 Chief, Division of Thoracic Surgery, CGMH at Chiayi

• 2000 – present Attending Staff, Division of Thoracic Surgery, CGMH

Rajesh Dharmaraj Babu

Consultant, Department of Cardiac, Thoracic and

Vascular Surgery, National University Heart Centre

Singapore

Experienced Vascular Surgeon with a demonstrated history of working in the

hospital & health care industry. Skilled in Research, Vascular, Clinical Research,

Medical Devices, and Vascular Surgery. Strong consulting professional with a

FRCS focused in Surgery from Royal college of surgeons Edinburgh.

Dr. Rajesh is also actively involved in Undergraduate and Postgraduate teaching

at the National University Health system and is currently a Clinical Lecturer at

Yong Loo Lin School of Medicine.

47


Scott Trerotola

Stanley Baum Professor of Radiology, University of

Pennsylvania School of Medicine in Philadelphi

CVI Research Description

As an interventional radiologist I have a longstanding interest in peripheral

vascular disease. My research focus has largely been in venous disease and

hemodialysis access with a particular focus in mechanical thrombectomy. My

clinical foci (and more recently research foci as well), as pertains to

cardiovascular disease in particular, are the management of pulmonary

arteriovenous malformations either related to or unrelated to hereditary

hemorrhagic telangiectasia, as part of the HHT center here at Penn; and venous

thromboembolic disease, in particular the management of removable inferior

vena caval filters.

Ta Wei Su

Attending Staff, Vascular Surgery, Chang Gung

Memorial Hospital, Linkou Medical Center

Experience

• 2012 – 2014 Chief Resident Fellow, Division of Thoracic &

Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Medical

center, Taiwan

• 2009 – 2012 R1~R3, Department of Surgery, Chang Gung Memorial

Hospital, Linkou Medical center, Taiwan

• 2004 – 2004 Internship, Department of Plastic Surgery, Klinikum

rechts der Isar TU Muenchen, Germany

48


Tan Ru Yu

Consultant, Department of Renal Medicine,

Singapore General Hospital

Specialties

• Renal Medicine, Interventional Nephrology

Awards

• Best Abstract Award 3rd Place, 4th Congress of Asian Pacific Society of

Dialysis Access

• Best Podium Abstract 2nd Place, Annual Scientific Meeting, American

Society of Diagnostic and Interventional Nephrology

• Best Poster Award (Education Research) SingHealth Duke-NUS Scientific

Meeting

• Service with a Heart Award, Singapore General Hospital

Tay Kiang Hiong

Head, Vascular and Interventional Radiology

Department, Singapore General Hospital

Dr. Tay is currently the Head of the Vascular and Interventional Radiology

Department and Assistant Chairman of the Radiological Sciences Division at

Singapore General Hospital. He is also the Academic Vice Chair of Clinical

Service Transformation for the Singhealth Duke NUS Radiological Sciences

Academic Clinical Program. He is Associate Professor at the Duke NUS Medical

School Singapore and at the Yong Loo Lin School of Medicine in National

University of Singapore.

49


Tiffany Chang

Manager Quality and IPC, Fresenius Medical Care

Asia Pacific

My name is Tiffany Chang. I graduated from nursing college on 1991 and work

in clinical field since then. I’m a Haemodialysis Nurse since 2005. During the

time I have completed my Nursing Diploma and I currently studying my master’s

degree major on Clinical Management at Asia University in Taichung. Be a

dialysis nurse is not my dream business, however it did inspire me to become a

better nurse than I expected. Haemodialysis treatment might look ordinary in

daily practices. It exits a lot of potential topic need to be discover for clinical staff.

Vascular access is one of the topics that need to be address and explore more.

I’m happy to be a haemodialysis nurse and I would like to contribute myself in

this field.

Tsann Long Hwang

Attending Staff, General Surgery, Chang Gung

Memorial Hospital

Tsann Long Hwang is an attending faculty and surgeon in general surgery in

Chang Gung Memorial Hospital in Taipei, Taiwan, where he is also the director

of the Pancreatic Cancer Team, and Chairman of the Committee of Enteral and

Parenteral Nutrition and Committee of Stem Cells and Tissue Engineering

Research. He is also a professor of surgery in the Chang Gung University,

College of Medicine, in Taiwan.

50


Yu Fei Wang

Attending Physician, Blood Purification Center, The

First Affiliated Hospital of Zhengzhou University

Dr. Yufei Wang is an attending physician in the Blood Purification Center of the

first affiliated hospital of Zhengzhou University. He is focusing on vascular

access of hemodialysis patients with 4 years of experience in this field.

Yu Wei Fang

Chief, Department of Nephrology, Shin Kong Wu Ho

Su Memorial Hospital

Specialties

• Hemodialysis

• Renal Transplant

• Renal Disease

• Dialysis

• Clinical Nephrology

• Peritoneal Dialysis

• Chronic Kidney Failure

51


Yu Zhu Wang

Chief, Department of Nephrology, Beijing Haidian

Section of Peking University Third Hospital

Experience

• 2005 – 2006 Associate Chief Surgeon, Department of Nephrology,

Beijing Haidian Section of Peking University Third Hospital

• 2000 – 2005 Associate Chief Surgeon, Department of Nephrology,

Peking University People’s Hospital

• 1995 – 2000 Attending Surgeon, Department of Nephrology, Peking

University People’s Hospital

• 1990 – 1995 Resident, Department of Nephrology, Peking University

People’s Hospital

Yu Jun Zhan

Registered Nurse, Peritoneal Dialysis Center of

National Taiwan University Hospital

Experience

• 2014 – present Registered nurse, Peritoneal Dialysis Center of National

Taiwan University Hospital

• 2009 – 2014 Registered nurse, Hemodialysis Center of National

Taiwan University Hospital

• 2004 – 2009 Registered nurse, medical ICU of National Taiwan

University Hospital

52


Zheng Ya Yu

Director, Department of General Surgery and

Vascular Surgery, Beijing Tongren Hospital, Capital

Medical University

Prof Zheng Ya Yu is a vascular and endovascular surgeon working in

department of vascular surgery, Beijing Tongren Hospital, Capital Medical

University. He graduated from University Duisburg-Essen School of Medicine,

Germany (MD). He received training in both open surgery and endovascular

intervention for Vascular Surgery in PUMC Hospital, Beijing China. He

completed his postdoctoral training in The Johns Hopkins University School of

Medicine, USA and in The Cleveland Clinic Foundation, USA from 2000-2001.

53


54


Name: Mr. Benjamin Lim

Abstract (Introduction, Methods, Results, Discussion)*

Background and Objectives

Arteriovenous grafts (AVG) are commonly used for haemodialysis access. Graft

thrombosis is one of the common complications arising from the use of AVGs, and can

lead to significant patient morbidity. Several modalities such as percutaneous thrombolysis,

or open surgical thrombectomy can be used for graft salvage. The purpose of this study is

to retrospectively compare outcomes between surgical thrombectomy and percutaneous

thrombolysis for the salvage of thrombosed upper limb AVGs.

Methods

A retrospective review of all patients who underwent salvage of thrombosed AVGs from

January 2014 to December 2018 was performed. Electronic medical records were

reviewed and data pertaining to patient demographics, comorbidities, AVG characteristics,

prior AVG interventions, current AVG intervention and procedural outcomes were collected.

Data analysis was performed using SPSS version 23. Dichotomous outcomes were

represented in percentages and compared using the independent T-test, whilst

continuous outcomes were represented in mean and compared using the Chi-square test.

Time to event outcome measures such as the 12-months primary and secondary patency

rates were represented as Kaplan-Meier curves and compared using the Log-rank test.

Multivariate analysis was further performed using the Cox regression model to adjust for

covariates. P values of less than 0.05 were taken to be statistically significant.

Results

A total of 222 salvage procedures (112 open thrombectomy and 110 percutaneous

thrombolysis) was performed. There were no significant differences between patient

demographics, antiplatelet and anticoagulation use, and graft characteristics. There was

no difference in procedural success rates (93.8% vs. 91.8%, p=0.578), or post-procedural

complications such as bleeding (3.6% vs. 2.7%, p=0.719), surgical site infection (2.6% vs.

1.8%, p=0.666). There was a trend towards more distal embolism in patients who

underwent percutaneous thrombolysis compared to open thrombectomy (2.7% vs. 8.2%,

p=0.070), although this was statistically not significant. There was also no difference in

the 12-month primary patency (log-rank 0.42) and secondary patency rates (log-rank 0.59)

between both group of patients.

Conclusion

The outcomes of open thrombectomy and percutaneous thrombolysis for salvage of

thrombosed upper limb AVGs are comparable, although there seems to be a trend

towards higher rates of distal embolism in patients who underwent percutaneous

thrombolysis.

55


56


57


Name: Dr. Lenny Suryani Safri

Abstract (Introduction, Methods, Results, Discussion)*

Methodology

This is a retrospective cohort study done in a single centre. Included were symptomatic

central venous obstructions' patients with positive central venogram following

arteriovenous fistula surgery. The end of the follow up was fixed at one year after CVO was

detected.

Result

Out of 89 patients who had positive central venogram, only 42 patients were identified as

first occurrence. Of the 42 patients; 45.2% were aged >65 years, 85.7% were diabetic,

95.2% were hypertensive, and 26.2% had hyperlipidemia. Total of 16 patients (38.1%)

developed mild central venous occlusion. 5 patients (11.9%) had severe central venous

stenosis and the remaining were classified as total occlusion of central veins. The primary

patency rates calculated according to survival analysis were 73% during the first 3 months

and 42% at one year. Bivariate analysis revealed that the factor affecting the primary

patency rate of AVF is left brachiocephalic vein lesion (P=0.034). However, there were no

other significant differences between the demographic factor (gender, age) and clinical

factors (comorbids, habit, antiplatelet usage, steroid usage, indwelling central venous

catheter) in relation to the CVO severity and the primary patency rate of AVF (P>0.05).

Discussion

The AVF patency, CVO severity and the contributing factors help in determining the

high-risk population to develop CVO that may eventually cause vascular access failure.

Our study showed that patients who develop CVO had the primary patency rate of 73%

during the first 3 months, 56% at 4th to 6th month and 41% at one year. We found a factor

that significantly decreases the primary patency: CVO at left brachiocephalic fistula

(P=0.034). The secondary patency rate was 78% during the first 3 months, 76% at 4th to

6th month and 66% at one year. The primary and secondary patency rates in our setting

were found to be lower in comparison to those reported by other authors . We postulated

that this could be due to the generally smaller veins size in our population that are known

to effect AVF patency.

In our study, demographic factors such age and gender did not influence the AVF patency

rate and CVO severity. Additional to this, we also found that the patients' comorbidities did

not have a significant effect on both outcomes. Other studies showed that diabetes

mellitus has significant correlation with AVF patency. However, in our study, we found no

significant correlations between diabetes mellitus with the AVF patency. This may be due

to proper optimization of glycemic control in our diabetes patients.

Conclusion

Central venous obstruction is a common problem occurring in patients with history of

indwelling central venous catheter. Location of lesion at the left brachiocephalic vein are

shown to have significant association with primary patency rate of fistula (P<0.05)

58


Name: Dr. Qi Tian Teo

Abstract (Introduction, Methods, Results, Discussion)*

Single-Institution experience with Surfacer, an inside-out device, together with HeRO graft

for salvage of vascular access in the challenging patient

The Surfacer Inside-Out Access Catheter System (Surfacer) is a novel approach to restore

access in central venous complete total occlusions (CTO). We report a series of 3 cases

from November 2018 to December 2019 in our institution where this technique was used

in tandem with Hemodialysis Reliable Outflow (HeRO) graft for salvage of vascular access

in patients with central CTO.

The Surfacer device is a stiff cannula loaded onto a 180cm long guidewire with a sharp tip

and deflectable needle guide. It is introduced through an 8Fr sheath in the femoral vein to

the level of occlusion. Under fluoroscopic guidance, the trajectory of the needle guide is

aligned with the target skin exit site. The sharp recanalization wire is advanced through the

needle guide and exteriorised. Using the established through-and-through wire access, a

peel-away sheath is introduced across the occlusion. A graft is then anastomosed to the

brachial artery or a pre-existing arterialised fistula. Angioplasty of the SVC is performed

followed by insertion of the venous outflow component (VOC) which is then connected to

the graft using a SuperHeRO adapter.

All 3 patients had failed prior conventional attempts at CTO crossing and had exhausted

most conventional vascular access methods. Patients B and C were already on femoral

catheters and patient A had recurrent CTO despite multiple interventions. The above

technique yielded a 100% success rate with mean operative time of 140 minutes (A=98,

B=119, C=205). Cannulation rate was 100% with all undergoing successful early

cannulation by post-operative day 3 (A=1, B=2, C=3). Post-operative complication was

seen in patient A who developed a hematoma from cannulation on POD7 requiring

evacuation. Post-operative thrombosis rate was 33% with patient B having a partially

thrombosed graft 3 months post-operatively requiring thrombolysis. No subsequent

access interventions were required for patients A and C. All vascular access remained in

use up to the time of writing with the longest dwell time of 9 months in patient A.

The Surfacer device used together with HeRO graft is a feasible technique to avoid

catheter femoral dependence in patients where conventional attempts to cross the central

CTO have failed.

59


Name: Dr. Rajendra Prasad Basavanthappa

Abstract (Introduction, Methods, Results, Discussion)*

Single Stage Basilic Vein Transposition - An Effective and Viable Autogenous Access for

Dialysis

Introduction

The National Kidney Foundation’s / Kidney Disease Outcomes Quality Initiative

recommends autogenous arteriovenous fistulas (AVF) as the preferred method for long

term hemodialysis access. Basilic vein transposition is an alternative in patients with failed

AV access. Several studies have shown better patency rates, cost-effectiveness and

fewer complications of autogenous access over prosthetic arteriovenous grafts.

Aims

To analyze patency, complication rates and outcomes of single stage basilic vein

transposition.

Materials & Methods

A single-center retrospective non-randomized study conducted in MS Ramaiah medical

college, Bangalore from Jan 2015 to December 2018. A total of 72 consented patients who

underwent single stage basilic vein transposition were included in the study. All the

surgeries were done in a single stage under regional anesthesia. All the complications,

patency rates were calculated at the end of 1 year. Statistical analysis was performed

using the Chi-square test and patency rates assessed using the Kaplan Meir survival

curve.

Results

A total of 72 single-stage BVT was performed. 44 patients had a previous failed forearm

autogenous access and 28 had either absent or thrombosed cephalic vein in the arm. The

mean age was 56.6yrs with 59.57% males. The mean basilic vein and brachial artery

diameter were 3.6mm and 3.8mm respectively. The primary patency rate at 1 year was

84%. Edema and thrombosis were the most common complication in our study.

Discussion

Single-stage basilic vein transposition is a feasible surgical option in end-stage renal

disease patients and provides durable autogenous access with reasonable patency and

fewer complication rates.

60


Name: Dr. Reuban D'cruz

Abstract (Introduction, Methods, Results, Discussion)*

Introduction

Stents are commonly deployed during endovascular maintenance or salvage of

dysfunctional haemodialysis access. Indications for stenting include immediate or early

lesion recoil or access perforation. In this study, we aim to investigate the effect of residual

lesion waisting on early outcomes after stenting.

Methods

A retrospective review of all endovascular procedures for the purpose of dialysis access

maintenance and salvage from 1st January 2016 to 30th June 2018 performed in a single

tertiary hospital was conducted. Patients who had stenting performed in the same

procedure after balloon angioplasty for the treatment of an occlusive or stenotic lesion

were identified. Electronic medical records were reviewed and relevant data such as

patient demographics and haemodialysis access characteristics were extracted. The

primary endpoint was freedom from clinically driven target lesion revascularization at

12-months (CD-TLR). Angiographic images were reviewed and patients were stratified

based on the presence of complete lesion effacement or residual lesion waisting after

balloon angioplasty prior to stent deployment. Statistical analysis was performed using

SPSS version 23.

Results

Stenting after balloon angioplasty was performed for a total of 31 patients. Univariate

analysis demonstrated that freedom from CD-TLR at 12-months for patients with

complete lesion effacement is significantly higher at 40.9%, as compared to 11.1% if there

is residual lesion waisting after balloon angioplasty (p=0.009, log-rank test). Multivariate

analysis using Cox regression accounting for potential confounders such as access type

and stent type showed that complete balloon effacement was associated with a trend to

higher freedom from CD-TLR at 12 months (HR 2.3; 95% CI 0.85-6.45; p=0.099).

Conclusions

Stent deployment should ideally be performed when complete balloon effacement of the

stenotic lesion can be achieved to ensure good outcomes. Stenting in the presence of

residual stenosis, as manifested by persistent balloon waisting, is associated with

increased re-interventions.

61


Name: Dr. Reuban D'cruz

Abstract (Introduction, Methods, Results, Discussion)*

Short-term outcomes of surgical residents compared with attending surgeons in the

creation of autogenous haemodialysis arteriovenous fistulae

Reuban D'cruz, Benjamin JH Lim, Andrew MTL Choong, Jun Jie Ng

Introduction

Hands on surgical training is important in the training and nurturing of young surgical

residents. However, there is still ongoing debate about the influence of experience or

seniority on surgical outcomes. In this study, we aim to evaluate the short-term outcomes

between surgical residents and attending surgeons in the creation of autogenous

haemodialysis arteriovenous fistulae (AVF).

Methods

A retrospective review of all patients who underwent upper limb AVF creation in a 3-year

period from 2016 to 2018 was performed. Electronic medical records were accessed and

reviewed. Patients were stratified into two groups according to the status of the main

operative surgeon, and comparison of patient demographics, operative time and AVF

maturation parameters were performed.

Results

A total of 590 AVF created from 1st January 2016 to 31st December 2018 were included in

this study. The majority of AVF were created by experienced surgeons (N=434, 73.6%),

whereas the rest were created by surgical residents under direct supervision of the

attending surgeons (N=156, 26.4%). There were no differences in patient demographics.

Surgical residents had a significantly longer operative time as compared to attending

surgeons (72.4 mins vs. 66.1 mins, 95% C.I. -10.9 to -1.7, P = 0.007). However, between

surgical residents and attending surgeons, there was no difference in the proportion of

fistulas that have successfully matured within 6 months (75.7% vs. 72.7%, P=0.447), and

no difference in the average time to maturation (105 days vs. 101 days, 95% C.I. -18.9 to

10.0, P = 0.542).

Conclusions

There is no difference in short-term maturation outcomes in the creation of autogenous

haemodialysis by surgical residents or attending surgeons, although the operative time

taken for surgical residents was significantly longer.

62


ACKNOWLEDGEMENTS

Sponsors

63


ACKNOWLEDGEMENTS

Sponsors

信 興 豐 科 技 股 份 有 限 公 司

Promedics Technology Co., Ltd

Government Sponsors

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