A Review of Percutaneous Transluminal Angioplasty in Hemodialysis Fistula

Bountouris, Ioannis; Kritikou, Georgia; Degermetzoglou, Nikolaos; Avgerinos, Konstantinos I.

doi:10.1155/2018/1420136

Cited by 37 publications

(46 citation statements)

References 49 publications

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“…Treatment of thrombosis requires urgent action by VA interventional expert consisting usually in a combination of thrombolytics and thrombectomy techniques [57][58][59]. After successful declotting, it is important to treat underlying stenosis by percutaneous balloon angioplasty to prevent thrombosis recurrence [60].…”

Section: Complications In Established Vamentioning

confidence: 99%

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Canaud¹,

Ponce²,

Parisotto³

et al. 2019

Vascular Access Surgery - Tips and Tricks

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A good functioning vascular access (VA) is a prerequisite to obtain a successful dialysis treatment. This chapter reviews VA management in advanced chronic kidney disease (CKD) patients drawn from the experience of a large network dialysis care provider with the following sections: overview on VA management in advanced CKD that follows patient pathway and patient profile, current practice patterns in line with best clinical practices; VA creation addressing crucial themes: when and what type of VA to construct, how to assess patient pre-emptively, how to proceed for the construction and monitoring to prevent early failures and complications; VA management with particular focus on clinical monitoring, surveillance and interventional procedures required to preserve patency and functionality of VA; the often-forgotten patient perspective is VA usage. What information to share, how to proceed for preventing pain, and fears related with VA needling? What should patients know about their VA and how to manage in daily life? Competences, skills and responsibilities of nursing staff when using and managing VA; and future of VA in terms of innovative concept for creating and maintaining VA conduits in dialysis patients.

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Section: Complications In Established Vamentioning

confidence: 99%

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Canaud¹,

Ponce²,

Parisotto³

et al. 2019

Vascular Access Surgery - Tips and Tricks

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“…Per Society of Interventional Radiology (SIR) guidelines, angioplasty is considered unsuccessful if, despite the use of high-pressure balloons, there is elastic recoil of the vein such that the stenosis remains >50% [8]. When a stent was placed, we considered this a technical failure of PTA.…”

Section: Resultsmentioning

confidence: 99%

Outcomes after Percutaneous Angioplasty of Arteriovenous Fistulas and Grafts in African American Patients

et al. 2019

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Purpose Arteriovenous fistulas and grafts, necessary for hemodialysis, may develop stenoses due to neointimal hyperplasia, which often require percutaneous transluminal angioplasty. Patient and lesion characteristics were evaluated prior to angioplasty and were correlated with 1- and 6-month outcomes. Materials and Methods This was an observational study of African American hemodialysis patients who presented for angioplasty of a dysfunctional fistula or graft. Clinical outcomes were ascertained from dialysis facilities 1 month and 6 months after angioplasty. One-month clinical success was defined as dialyzer blood flows of 450 mL/min without complications or interval shunt thrombosis, interventions, or loss of access, which was rarely achieved at 6 months. Logistic regression models were used to evaluate associations of clinical variables with outcomes. Results There were 150 stenoses treated during 99 procedures performed on 82 patients. The clinical success rate at one month was 67% with no complications as a result of the percutaneous transluminal angioplasty. Success at 1 month was positively associated with use of aspirin ( P = .005) and with referral for high venous pressures ( P = .004). Six-month data were available for 81 procedures, with 45.7% requiring repeat angioplasty and 12.3% suffering major complications (thrombectomy, revision surgery, or access abandonment). Major complications were seen predominantly in patients who were not receiving aspirin. Conclusions Aspirin use and high venous pressure were associated with 1-month clinical success and fewer major complications at 6 months. Future work should investigate biologic mechanisms of action of aspirin and long-term effects of use to maintain vascular access.

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“…Permanent tunneled venous catheters are the last access when a patient has lost all the possible sites for an AVF or AVG. [4] These dialysis grafts and fistulas have limited durability of about 3 years and are more prone for thrombosis and stenosis, resulting in AVF dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Endovascular Treatment of Stenosis of Dialysis Arteriovenous Fistulas

Pasupuleti

Samireddypalle

Vijay

et al. 2020

AJMRR

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Background: The incidence of end stage renal disease is on the rise and most of these patients are undergoing dialysis either through tunneled/non tunneled dialysis catheters or through arteriovenous fistulas. The dialysis grafts and fistulas have limited durability of about 3 years and are more prone for thrombosis and stenosis, resulting in AVF dysfunction. As the number of access sites for dialysis is limited, percutaneous endovascular management by fistuloplasty has become the accepted first line of management to increase the lifespan of these fistulas.This article discusses a series of cases of AVF dysfunction secondary to draining vein stenosis managed by percutaneous transluminal angioplasty, their outcome and short term follow up till 3 months. The aim of the study is to review the role of percutaneous endovascular management of stenosis of dialysis fistulas, its indications, safety, efficacy and short term patency. Subjects and Methods: This was a prospective observational study done in department of Radio diagnosis, Narayana medical college, Nellore. About 20 cases were performed in our institution from December 2018 to August 2019. All these cases were done in angio suite after proper dialysis through temporary catheter. Post procedure doppler was done to evaluate the improvement in flow rate of these fistulas. Results: Seventeen cases were successful with immediate restoration of optimal flow rate during dialysis. (One case developed acute thrombosis of the fistula within 24 hours post procedure, which was successfully treated by needle directed thrombolysis with good patency at three month follow up). In two cases, there was failure of the procedure as the tight stenotic segment could not be negotiated. One case had early re-stenosis of the draining vein which required repeat session of fistuloplasty within one month with occlusion of the draining vein on three month follow up. Conclusion: Fistuloplasty is a minimally invasive percutaneous procedure with established safety and efficacy to restore the normal function of dialysis fistulae/grafts. The main aim of the procedure is to restore a diameter of the draining vein adequate for optimal flow rate during dialysis. Careful patient selection is required for increasing the success rate of the procedure. Repeat sessions of angioplasty is offered for re-stenosis to increase the lifespan of fistulas. Stent placement is usually avoided except for recurrent focal stenosis in precious fistulas.

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A Review of Percutaneous Transluminal Angioplasty in Hemodialysis Fistula

Cited by 37 publications

References 49 publications

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Vascular Access Management for Haemodialysis: A Value-Based Approach from NephroCare Experience

Outcomes after Percutaneous Angioplasty of Arteriovenous Fistulas and Grafts in African American Patients

Percutaneous Endovascular Treatment of Stenosis of Dialysis Arteriovenous Fistulas

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