Balloon Angioplasty for Low-Flow Access

Rajan, Dheeraj K.

doi:10.5301/jva.5000344

Cited by 3 publications

(2 citation statements)

References 18 publications

(19 reference statements)

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“…A percutaneous approach to DA stenosis by PTA has been long established as the best treatment in most cases and used as the gold standard (14,18,19). The primary patency rates after PTA of DA regardless of location (arm, forearm) vary widely in the literature and are about 25-30% for AVG and 67% for AVF at 1 year (3).…”

Section: Discussionmentioning

confidence: 99%

Treatment of failing arterio‑venous dialysis graft by angioplasty, stent, and stent graft: Two‑years analysis of patency rates and cost‑effectiveness

et al. 2019

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The objective of this prospective randomized single-center study was to compare primary and secondary patency rates, number of percutaneous transluminal angioplasty (PTA) interventions and cost-effectiveness among PTA, deployment of a stent, or a stent graft in the treatment of failing arteriovenous dialysis grafts (AVG) due to restenosis in the venous anastomosis or the outflow vein. Altogether 60 patients with failing AVG and restenosis in the venous anastomosis or the outflow vein were randomly assigned to either PTA, placement of a stent (E-Luminexx ®) or stent graft (Fluency Plus ®). After the procedure, patients with stent or stent graft received dual antiplatelet therapy for the next three months. Follow-up angiography was scheduled at 3, 6, and 12 months unless requested earlier due to suspected stenosis or malfunction of the access. Subsequently, angiography was performed only if requested by the clinician. During a median follow-up of 22.4 (IQR=5.7) months patients with PTA, stent, or stent graft required 3.1±1.7, 2.5±1.7, or 1.7±2.1 (P= 0.031) secondary PTA interventions. The primary patency rates were 0, 18 and 65% at 12 months and 0, 18 and 37% at 24 months in the PTA, stent, and stent graft group respectively (P<0.0001). The cost of the procedures in the first two years was €7,900±€3,300 in the PTA group, €8,500±€4,500 in the stent group, and €7,500±€6,200 in the stent graft group (P= 0.45). We conclude that the treatment of failing dialysis vascular access by the deployment of a stent graft significantly improves its primary patency rates and decreases the number of secondary PTA interventions; however, the reduction in costs for maintaining AVG patency is not significant.

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Section: Discussionmentioning

confidence: 99%

Treatment of failing arterio‑venous dialysis graft by angioplasty, stent, and stent graft: Two‑years analysis of patency rates and cost‑effectiveness

et al. 2019

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“…In addition, the patency rates of all cases of occlusion treatment as well as those of cases using biopsy forceps were superior. 13–17 It is considered that the appropriate selection of treatment improved the overall patency rate of the occlusion cases. It is important to determine which cases of occlusion endovascular treatment or surgical revascularization will be suitable for the appropriate use of biopsy forceps.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided removal of organized thrombi using biopsy forceps in dialysis patients with arterio-venous access occlusion

Wakabayashi¹

2019

J Vasc Access

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Introduction: As a countermeasure against the organized thrombi frequently observed in vascular access occlusion, we devised a percutaneous excision method for organized thrombi under superficial ultrasound guidance using biopsy forceps. The Radial JawTM 3 (2 mm) biopsy forceps of Boston Scientific Corporation was used. The usefulness of this method was investigated. Method: The following protocol, which is suitable for endovascular treatment, was prepared and used: (1) all procedures were performed under ultrasound guidance and (2) use of the forceps was assisted via a long sheath in cases involving a complicated bloodstream. Subjects: Among 564 cases of arterio-venous access occlusion that received treatment at this hospital between May 2014 and April 2017, the subjects of this study were 468 cases who could be followed up. Thrombectomy of an organized thrombus using the biopsy forceps was performed 194 times in 138 cases. Biopsy forceps were used in the initial treatment in a total of 115 cases, including 71 cases of acute occlusion of an autologous vein, 3 cases of chronic occlusion of an autologous vein, and 41 cases of acute occlusion of a prosthetic vessel. Results: The initial success rate for all cases of occlusion was 97.2%. The initial success rate for cases in which biopsy forceps were used was 98.2%. For cases using biopsy forceps, the primary patency rates were 47.1% at 3 months, and the secondary patency rates (until occlusion) were 89.1% at 3 months. Conclusion: This method was considered to be a valuable choice as a countermeasure against organized thrombi.

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Diagnostik und endovaskuläre Therapie venöser Erkrankungen

Kamper

Altenburg

Das³

et al. 2017

Radiologe

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In venous disease, acute thromboses and chronic venous insufficiency have the highest health economics relevance. Duplex sonography is the first line diagnostic assessment tool, while cross-sectional imaging is employed as a supplementary method. Due to the availability and examination times computed tomography is preferred in the emergency setting and is supplemented by magnetic resonance imaging (MRI) for specific questions. Endovascular treatment procedures are increasingly becoming available in addition to classical conservative treatment methods.

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Balloon Angioplasty for Low-Flow Access

Cited by 3 publications

References 18 publications

Treatment of failing arterio‑venous dialysis graft by angioplasty, stent, and stent graft: Two‑years analysis of patency rates and cost‑effectiveness

Treatment of failing arterio‑venous dialysis graft by angioplasty, stent, and stent graft: Two‑years analysis of patency rates and cost‑effectiveness

Ultrasound-guided removal of organized thrombi using biopsy forceps in dialysis patients with arterio-venous access occlusion

Diagnostik und endovaskuläre Therapie venöser Erkrankungen

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