Occlusion of a Rapidly Expanding Hemodialysis Graft Pseudoaneurysm with Placement of a Stent Graft

Moszkowicz, Arie; Behrens, George; Gueyikian, Sebouh; Patel, Nilesh H.; Ferral, Héctor

doi:10.1055/s-2007-971183

Cited by 18 publications

(17 citation statements)

References 12 publications

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“…14 Following the introduction of covered stent grafts, other investigators have also described their use for the treatment of hemodialysis access PSA. 3,[6][7][8]15,16 We believe our study represents the largest single institution experience that has been published to date.…”

Section: Discussionmentioning

confidence: 90%

Endovascular treatment of hemodialysis access pseudoaneurysms

Shah¹,

Valdes²,

Charlton-Ouw³

et al. 2012

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 90%

Endovascular treatment of hemodialysis access pseudoaneurysms

Shah¹,

Valdes²,

Charlton-Ouw³

et al. 2012

Journal of Vascular Surgery

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“…The mean number of stents used to treat one pseudoaneurysm was 1.4. As described by Moszkowicz et al., “true pseudoaneurysms” with narrow necks can be easily treated with one stent, whereas wide neck pseudoaneurysms, which are rather areas of graft degeneration than pseudoaneurysms, require more than one stent and are more prone to endoleaks.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of arteriovenous graft pseudoaneurysms, indications, complications, and outcomes: A systematic review

Florescu

Qiu

Plumb

et al. 2014

Hemodialysis International

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There are limited data regarding endovascular treatment of arteriovenous graft (AVG) pseudoaneurysms using stent grafts. We performed a comprehensive literature review on the use of stent grafts in the treatment of AVG pseudoaneurysms. We included 10 studies (121 patients). The mean AVG age was 3.1 years (95% confidence interval [CI]: 2.2-4) and pseudoaneurysm mean diameter was 34 mm (95% CI: 23-46). The majority (71%) of the pseudoaneurysms were located on the arterial limb of the AVG and 77% presented with venous anastomosis stenosis requiring angioplasty. The mean number of stents used to treat one lesion was 1.4 (95% CI: 1.3-1.5). The technical success rate of pseudoaneurysm isolation was 100% in all studies and 100% of patients received hemodialysis using the AVG after pseudoaneurysm treatment without the need for catheter placement. The primary patency rates for 1, 3, and 6 months were 81%, 73%, and 24%. Secondary patency was 80%, 77%, and 74% at 1, 3, and 6 months. Arteriovenous graft thrombosis occurred in 12% of patients. Arteriovenous graft infection developed in 35% of cases. Arteriovenous graft pseudoaneurysm treatment using stent grafts is effective in managing even large pseudoaneurysms and has acceptable primary and secondary patency rates. Graft infection was a relatively frequent complication.

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“…13 The different types of covered stents that have been used in endovascular treatment have been previously described. 12,[14][15][16][17][18][19] Endovascular access aneurysm repair is usually performed as an outpatient procedure, 20 and early dialysis venipuncture is encouraged to return the patient to an uninterrupted dialysis regimen. 15,17 Although not specifically designed for hemodialysis needle puncture, commercially available covered stent devices can endure repeated punctures to extend the use of the access for hemodialysis for many years (Fig 3).…”

Section: Discussionmentioning

confidence: 99%