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Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis.

Neuen BL, Baer RA, Grainer F, Mantha ML - Int J Vasc Med (2015)

Bottom Line: The clinical and anatomical success rate was 98.3% (59/60).Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively.Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, QLD 4870, Australia ; School of Medicine and Dentistry, James Cook University, Cairns, QLD 4870, Australia.

ABSTRACT
This study aims to report the outcomes of nitinol and polytetrafluoroethylene covered stent placement to treat hemodialysis arteriovenous access stenosis at a single center over a five-year period. Clinical and radiological information was reviewed retrospectively. Poststent primary and secondary patency rates were determined using Kaplan-Meier analysis. Ten clinical variables were subjected to multivariate Cox regression analysis to determine predictors of patency after stent placement. During the study period 60 stents were deployed in 45 patients, with a mean follow-up of 24.5 months. The clinical and anatomical success rate was 98.3% (59/60). Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively. Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively. Stent placement for upper arm lesions and in access less than 12 months of age was associated with reduced primary patency (adjusted hazards ratio [HR] 5.1, p = 0.0084, and HR 3.5, p = 0.0029, resp.). Resistant or recurrent stenosis can be successfully treated by endovascular stent placement with durable long-term patency, although multiple procedures are often required. Stent placement for upper arm lesions and in arteriovenous access less than 12 months of age was associated with increased risk of patency loss.

No MeSH data available.


Related in: MedlinePlus

Locations of stent deployment.
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Related In: Results  -  Collection


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fig1: Locations of stent deployment.

Mentions: Location of stent placement was classified according to a seven-zone system modified from previous studies (Figure 1) [4, 8]: arterial inflow, anastomosis, juxta-anastomosis (distal 5 cm of cephalic vein adjacent to the arteriovenous anastomosis), forearm venous outflow, upper arm venous outflow, cephalic arch (proximal 5 cm of the cephalic vein), and central veins. In the case of brachiobasilic saphenous vein grafts and PTFE grafts, vein-vein anastomotic stenosis and vein-graft anastomotic stenosis were grouped with juxta-anastomotic stenosis.


Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis.

Neuen BL, Baer RA, Grainer F, Mantha ML - Int J Vasc Med (2015)

Locations of stent deployment.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4663359&req=5

fig1: Locations of stent deployment.
Mentions: Location of stent placement was classified according to a seven-zone system modified from previous studies (Figure 1) [4, 8]: arterial inflow, anastomosis, juxta-anastomosis (distal 5 cm of cephalic vein adjacent to the arteriovenous anastomosis), forearm venous outflow, upper arm venous outflow, cephalic arch (proximal 5 cm of the cephalic vein), and central veins. In the case of brachiobasilic saphenous vein grafts and PTFE grafts, vein-vein anastomotic stenosis and vein-graft anastomotic stenosis were grouped with juxta-anastomotic stenosis.

Bottom Line: The clinical and anatomical success rate was 98.3% (59/60).Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively.Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, QLD 4870, Australia ; School of Medicine and Dentistry, James Cook University, Cairns, QLD 4870, Australia.

ABSTRACT
This study aims to report the outcomes of nitinol and polytetrafluoroethylene covered stent placement to treat hemodialysis arteriovenous access stenosis at a single center over a five-year period. Clinical and radiological information was reviewed retrospectively. Poststent primary and secondary patency rates were determined using Kaplan-Meier analysis. Ten clinical variables were subjected to multivariate Cox regression analysis to determine predictors of patency after stent placement. During the study period 60 stents were deployed in 45 patients, with a mean follow-up of 24.5 months. The clinical and anatomical success rate was 98.3% (59/60). Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively. Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively. Stent placement for upper arm lesions and in access less than 12 months of age was associated with reduced primary patency (adjusted hazards ratio [HR] 5.1, p = 0.0084, and HR 3.5, p = 0.0029, resp.). Resistant or recurrent stenosis can be successfully treated by endovascular stent placement with durable long-term patency, although multiple procedures are often required. Stent placement for upper arm lesions and in arteriovenous access less than 12 months of age was associated with increased risk of patency loss.

No MeSH data available.


Related in: MedlinePlus