[Does interventional therapy prolong the patency of hemodialysis fistulas and grafts?].

Abstract

PURPOSE:

To retrospectively evaluate procedural success and patency after endovascular treatment of acute dysfunctional hemodialysis fistulas and grafts in a non-preselected patient cohort.

MATERIALS AND METHODS:

185 angiographies of hemodialysis fistulas and grafts on the upper extremities were analyzed for 120 patients (53 male, 67 female; mean-age 63.1 +/- 11.4, range 24 - 91). 70 % (n = 130) were native arteriovenous fistulas, 17 % (n = 31) were prosthetic grafts, and 13 % (n = 24) were non-specific. In total, 278 lesions requiring endovascular treatment were detected. 13 % (n = 35) of the lesions were located in the arterial inflow, 18 % (n = 49) in native arteriovenous anastomoses, 7 % (n = 19) in prosthetic grafts and 62 % (n = 171) in the venous outflow. The primary, secondary and cumulative patency after endovascular treatment was calculated.

RESULTS:

In 51 % (n = 94) of the cases endovascular treatment could be performed, in 8 % (n = 14) no lesion requiring treatment was detected, and in 42 % (n = 77) intervention was not considered possible. In 45 % (n = 124) of the detected lesions endovascular treatment was successful, in 18 % (n = 51) the intervention failed, and in 37 % (n = 103) intervention was not considered possible. The complication rate was 5 % (n = 10). The primary, secondary, and cumulative patency rates for 50 % of the hemodialysis fistulas and grafts after endovascular treatment were 65, 191, and 370 days, respectively. The results differed significantly from each other with p < 0.05 in the log rank test and log rank trend test.

CONCLUSION:

Endovascular treatment of acute dysfunctional hemodialysis fistulas and grafts is effective in restoring the patency for hemodialysis.

• Authors: P J Schaefer, S Müller-Hülsbeck, F K Schaefer, J Soehne, N Charalambous, M Heller, T Jahnke
• Journal: RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (Rofo) Vol. 178 Issue 11 Pg. 1121-7 (Nov 2006) ISSN: 1438-9029 [Print] Germany
• Vernacular Title: Verlängert die radiologisch-interventionelle Therapie die Shuntnutzungsdauer bei hämodialysepflichtigen Patienten?
• PMID: 17128380 (Publication Type: Journal Article)

Topics

• Acute Disease
• Adult
• Aged
• Aged, 80 and over
• Angiography
• Angioplasty, Balloon
• Arteriovenous Shunt, Surgical
• Blood Vessel Prosthesis
• Cohort Studies
• Female
• Graft Occlusion, Vascular (diagnostic imaging, therapy)
• Humans
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging)
• Prosthesis Failure
• Renal Dialysis
• Retrospective Studies
• Vascular Patency (physiology)