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Percutaneous transluminal angioplasty in the treatment of stenosis of arteriovenous fistulae for hemodialysis.

Miquelin DG, Reis LF, da Silva AA, de Godoy JM - Int Arch Med (2008)

Bottom Line: Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure.Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae.Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.

View Article: PubMed Central - HTML - PubMed

Affiliation: Livre Docente of the Cardiology and Cardiovascular Surgery Department of the Medical School in São José do Rio Preto (FAMERP), Professor of the Graduation and post graduation courses of FAMERP and CNPq researcher, Brazil. godoyjmp@riopreto.com.br.

ABSTRACT

Background: Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure. Percutaneous transluminal angioplasty is being used more frequently in the treatment of stenosis aiming at increasing the patency of arteriovenous fistulae.

Objective: To evaluate the primary patency of arteriovenous fistulae following percutaneous transluminal angioplasty.

Patients and method: Patients submitted to percutaneous transluminal angioplasty in the Angiology service of Hospital de Base in 2004 were analyzed over an average follow-up of 10 months (2 to 16 months).

Results: A total of 22 angioplasties were performed in 20 fistulae of 19 patients. Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae. The following complications occurred in the remaining 18 fistulae, three deaths with two fistulae patent until death; one exeresis of prosthesis due to infection (53 days after the procedure); two thromboses (3 and 49 days after the procedure) and four restenosis (3 were submitted to a second angioplasty and one treated surgically). At the end of the follow-up, 11 fistulae (55%) were patent and with a flow rate in hemodialysis > 300 mL/min. Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.

Conclusion: Percutaneous transluminal angioplasty is an efficacious method for the correction of stenosis of arteriovenous fistulae for hemodialysis, prolonging the patency of the fistula and enabling new interventions.

No MeSH data available.


Related in: MedlinePlus

Angiographic study showing proximal stenosis at the anastomosis of the PTFE prosthesis and the axillary vein.
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Figure 1: Angiographic study showing proximal stenosis at the anastomosis of the PTFE prosthesis and the axillary vein.

Mentions: The angiographic technique employed in all cases was by venous puncture or puncturing the prosthesis using a 21 needle, the injection of contrast and obtaining digital angiographic images from the arteriovenous anastomosis up to the central veins. If significant stenosis was present, angioplasty was performed immediately (Figure 1 and 2).


Percutaneous transluminal angioplasty in the treatment of stenosis of arteriovenous fistulae for hemodialysis.

Miquelin DG, Reis LF, da Silva AA, de Godoy JM - Int Arch Med (2008)

Angiographic study showing proximal stenosis at the anastomosis of the PTFE prosthesis and the axillary vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2563000&req=5

Figure 1: Angiographic study showing proximal stenosis at the anastomosis of the PTFE prosthesis and the axillary vein.
Mentions: The angiographic technique employed in all cases was by venous puncture or puncturing the prosthesis using a 21 needle, the injection of contrast and obtaining digital angiographic images from the arteriovenous anastomosis up to the central veins. If significant stenosis was present, angioplasty was performed immediately (Figure 1 and 2).

Bottom Line: Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure.Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae.Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.

View Article: PubMed Central - HTML - PubMed

Affiliation: Livre Docente of the Cardiology and Cardiovascular Surgery Department of the Medical School in São José do Rio Preto (FAMERP), Professor of the Graduation and post graduation courses of FAMERP and CNPq researcher, Brazil. godoyjmp@riopreto.com.br.

ABSTRACT

Background: Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure. Percutaneous transluminal angioplasty is being used more frequently in the treatment of stenosis aiming at increasing the patency of arteriovenous fistulae.

Objective: To evaluate the primary patency of arteriovenous fistulae following percutaneous transluminal angioplasty.

Patients and method: Patients submitted to percutaneous transluminal angioplasty in the Angiology service of Hospital de Base in 2004 were analyzed over an average follow-up of 10 months (2 to 16 months).

Results: A total of 22 angioplasties were performed in 20 fistulae of 19 patients. Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae. The following complications occurred in the remaining 18 fistulae, three deaths with two fistulae patent until death; one exeresis of prosthesis due to infection (53 days after the procedure); two thromboses (3 and 49 days after the procedure) and four restenosis (3 were submitted to a second angioplasty and one treated surgically). At the end of the follow-up, 11 fistulae (55%) were patent and with a flow rate in hemodialysis > 300 mL/min. Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.

Conclusion: Percutaneous transluminal angioplasty is an efficacious method for the correction of stenosis of arteriovenous fistulae for hemodialysis, prolonging the patency of the fistula and enabling new interventions.

No MeSH data available.


Related in: MedlinePlus