Augmented Balloon-assisted Maturation (aBAM) for Nonmaturing Dialysis Arteriovenous Fistula

Samett, Evan J.; Hastie, Joshua; Chopra, Paramjit; Pradhan, Sujit Kumar; Ahmad, Iftikhar; Chiramel, Terence; Joseph, Reginald

doi:10.5301/jva.2010.6018

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Furthermore, recently, endovascular interventions have expanded to include “balloon‐assisted maturation” (BAM) for AVF maturation. BAM has been reported in several publications as a routine procedure to promote AVF maturation in nonmaturing AVFs (31,32) and to dilate vessels even prior to AVF creation (33). Until novel and locally delivered therapies are developed to better treat the endothelial injury that occurs as the result of angioplasty, endovascular interventions to treat AVF stenosis will probably continue to be plagued by poor primary patency and cumulative survival compared with surgery (11–13).…”

Section: Discussionmentioning

confidence: 99%

Improved Cumulative Survival in Fistulas Requiring Surgical Interventions to Promote Fistula Maturation Compared with Endovascular Interventions

Lee

Tindni

Roy‐Chaudhury

2012

Seminars in Dialysis

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Due to high non-maturation rates, arteriovenous fistulas (AVF) frequently require intervention(s) to promote maturation. Endovascular or surgical interventions are often undertaken to salvage non-maturing AVFs. The objective of this study was to compare the impact of surgical versus endovascular interventions to promote AVF maturation on cumulative AVF survival. We evaluated 89 patients with new AVF placement from a Veterans Affairs population over a 5-year period. Of these, 46 (52%) required intervention(s) to achieve successful maturation for dialysis. 31 patients had surgical revisions and 15 patients had endovascular repairs. We compared cumulative survival between AVFs requiring no intervention, surgical revision, and endovascular intervention to promote AVF maturation. Cumulative survival was longer in AVFs receiving surgical intervention compared to angioplasty to promote AVF maturation (p=0.05). One year cumulative survival was 86% vs 83% vs 40% for no intervention vs. surgery vs. angioplasty, respectively. In AVFs that required interventions to promote maturation, AVFs with surgical intervention had longer cumulative survival compared to those AVFs with endovascular intervention. AVFs with surgical intervention to promote maturation had similar one-year cumulative survival to those AVFs that did not require intervention to promote maturation.

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Section: Discussionmentioning

confidence: 99%

Improved Cumulative Survival in Fistulas Requiring Surgical Interventions to Promote Fistula Maturation Compared with Endovascular Interventions

Lee

Tindni

Roy‐Chaudhury

2012

Seminars in Dialysis

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“…Therefore, an upsurge of new techniques and studies has emerged in an effort to increase maturation and salvage rates in AVFs [ 2 ]. Balloon-assisted maturation (BAM) is a recent, innovative, yet controversial method for developing AVF maturation [ 2 3 ]. The use of BAM is becoming increasingly popular, despite the limited number of evidence-based studies and lack of randomized prospective trials [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…This method has been used in effort to increase successful primary maturation as defined by the National Kidney Foundation - Disease Outcomes Quality Initiative (NKF-DOQI) [ 2 4 ]. For that, the AVF MF is subjected to a series of staged, serial long-segment angioplasty dilations until it reaches the desired diameter and flow rate [ 3 ]. A successful BAM can rapidly speed up the maturation process and reduce the need for a tunneled dialysis catheter and prosthetic grafts [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…For that, the AVF MF is subjected to a series of staged, serial long-segment angioplasty dilations until it reaches the desired diameter and flow rate [ 3 ]. A successful BAM can rapidly speed up the maturation process and reduce the need for a tunneled dialysis catheter and prosthetic grafts [ 3 ]. Therefore, we evaluated the effectiveness of BAM for AVF MF in our early period experience.…”

Section: Introductionmentioning

confidence: 99%

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Balloon-assisted maturation for arteriovenous fistula maturation failure: an early period experience

Park

Kim

et al. 2016

Ann Surg Treat Res

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PurposeBalloon-assisted maturation (BAM) is emerging as a salvage management for arteriovenous fistula maturation failure (AVF MF). However, BAM is a relatively new, yet controversial technique for AVF maturation. Therefore, we evaluated the effectiveness of BAM for AVF MF.MethodsBetween January 2012 and December 2014, 249 AVFs were created. The total MF rate was 24.8%. But, only 110 AVFs were enrolled, including 74 brachiocephalic (BC) AVFs and 36 radiocephalic (RC) AVFs. The follow-up period was 12 months. Among those, there were 42 MFs (22 BC AVFs and 20 RC AVFs) and 68 maturation successes (MS) (52 BC AVFs and 16 RC AVFs). BAM was involved in MF group. We compared the clinical characteristics, AVF flows, and AVF flow ratios of MF and MS groups. Also, we evaluated the etiology, management, and result of MF.ResultsThere was no difference in clinical characteristics between MF and MS groups. In MF group, 39 balloon angioplasties (BAs) for 42 AVF MFs were performed. Number of BA was 1.45 ± 0.57 and duration of BA was 21.30 ± 21.24 weeks. BAM rate was 46.2%. For 1 year after AVF creation, AVF flows of MS group were significantly larger than those of MF group (P < 0.05) but there was no difference in AVF flow ratio between MF and MS groups (P > 0.05).ConclusionBA for AVF MF is a relatively applicable and effective modality. Although a large volume study is necessary, we suggest BAM is an effective salvage management for AVF MF.

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“…Balloon-assisted maturation (BAM) techniques can be an effective tool to help a dialysis patient achieve an adequately mature AVF. Additional vascular interventional techniques may be utilized to further improve clinical results; this technique is the so called "augmented balloon-assisted maturation" or aBAM [60] . Arteriovenous fistulas complications: Complications of AVFs can be divided into early and late causes.…”

Section: Permanent Vamentioning

confidence: 99%

Vascular access today

Pantelias

Grapsa²

2012

WJN

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The number of patients with chronic kidney disease requiring renal replacement therapy has increased worldwide. The most common replacement therapy is hemodialysis (HD). Vascular access (VA) has a key role for successful treatment. Despite the advances that have taken place in the field of the HD procedure, few things have changed with regards to VA in recent years. Arteriovenous fistula (AVF), polytetrafluoroethylene graft and the cuffed double lumen silicone catheter are the most common used for VA. In the long term, a number of complications may present and more than one VA is needed during the HD life. The most common complications for all of VA types are thrombosis, bleeding and infection, the most common cause of morbidity in these patients. It has been estimated that VA dysfunction is responsible for 20% of all hospitalizations. The annual cost of placing and looking after dialysis VA in the United States exceeds 1 billion dollars per year. A good functional access is also vital in order to deliver adequate HD therapy. It seems that the native AVF that Brescia and Cimino described in 1966 still remains the first choice for VA. The native forearm AVFs have the longest survival and require the fewest interventions. For this reason, the forearm AVF is the first choice, followed by the upper-arm AVF, the arteriovenous graft and the cuffed central venous catheter is the final choice. In conclusion, VA remains the most important issue for patients on HD and despite the technical improvements, a number of problems and complications have to be resolved.

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Augmented Balloon-assisted Maturation (aBAM) for Nonmaturing Dialysis Arteriovenous Fistula

Cited by 6 publications

References 9 publications

Improved Cumulative Survival in Fistulas Requiring Surgical Interventions to Promote Fistula Maturation Compared with Endovascular Interventions

Improved Cumulative Survival in Fistulas Requiring Surgical Interventions to Promote Fistula Maturation Compared with Endovascular Interventions

Balloon-assisted maturation for arteriovenous fistula maturation failure: an early period experience

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