How is Arteriovenous Fistula Longevity Best Prolonged?

Yevzlin, Alexander S.; Melnick, David M.

doi:10.1111/sdi.12305

Cited by 2 publications

(2 citation statements)

References 7 publications

(9 reference statements)

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“…The presence of a stent also improves the ease with which the fistula can be needled [11]. Stent placement has been safely and successfully used to salvage failing AVFs [12,13]. The use of stents may prevent elastic recoil and allow for a larger acute lumen to facilitate needle access.…”

Section: Introductionmentioning

confidence: 99%

Use of Paclitaxel Eluting Stents in Arteriovenous Fistulas: A Pilot Study

Dinh

Thomas

Cho

et al. 2019

VSI

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PurposeWe report short-term patency outcomes of a proof of concept study conducted to determine the efficacy of drug-eluting stent (DES) for the treatment of arteriovenous fistula (AVF) stenosis in hemodialysis patients.Materials and MethodsThis is a single-center, retrospective observational study involving 10 patients with AVF dysfunction treated with DESs between January 2017 and December 2017. The primary outcome was AVF patency confirmed by sonographic and clinical assessment at 1 month and 6 to 9 months after treatment.ResultsA total of 12 DESs were deployed in 10 patients with dysfunctional AVF (radiocephalic: 7, brachiocephalic: 3). During the early follow up (mean: 28.6 days), primary access circuit and DES patency was 100%, with an average volume flow rate of 886.4 mL/min. Nine patients were available for short-term follow up (mean: 202.4 days; 1 unrelated death), with a mean volume flow rate of 1,048.9 mL/min. The primary DES patency was 7/9 (77.8%), and 3 patients required angioplasty at other parts of the circuit (primary access circuit patency: 4/9 [44.4%]). The assisted primary access circuit patency was 77.8%. In 2 patients, the ultrasound revealed that the DESs were thrombosed without any antecedent stenosis; they were salvaged with angioplasty. Both patients previously underwent 2 DESs implanted and recently stopped dual antiplatelet therapy. B-mode sonographic assessment at all timepoints showed minimal intimal ingrowth on the stent struts.ConclusionThis study demonstrates acceptable short-term patency for DESs in the treatment of AVF stenosis. Dual antiplatelet therapy is probably mandatory in the short term.

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Section: Introductionmentioning

confidence: 99%

Use of Paclitaxel Eluting Stents in Arteriovenous Fistulas: A Pilot Study

Dinh

Thomas

Cho

et al. 2019

VSI

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“…While the benefit of in-line flow to the central veins has long been established for dialysis access circuits, the utility of using stent grafts to accomplish this has been described only rarely. 5,23,24 Stent grafts have traditionally been used more frequently to isolate pseudoaneurysms that occur due to repeated venipuncture, or secondary to angioplasty-induced venous ruptures. [25][26][27] Additionally, the use of stent grafts placed close to the fistula itself may or may not be contraindicated due to the possibility of damaging the stent graft material during venous access for dialysis.…”

Section: Discussionmentioning

confidence: 99%

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

Patel

Ray

Lokken

et al. 2016

Semin intervent Radiol

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Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations.

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How is Arteriovenous Fistula Longevity Best Prolonged?

Cited by 2 publications

References 7 publications

Use of Paclitaxel Eluting Stents in Arteriovenous Fistulas: A Pilot Study

Use of Paclitaxel Eluting Stents in Arteriovenous Fistulas: A Pilot Study

Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

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