Percutaneous Transluminal Angioplasty in Japan: Five-Center Investigation

Murakami, Masaaki; Miyamoto, Masahito; Suemitsu, Kotaro

doi:10.5301/jva.5000426

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…2 However, the primary patency rate at 6 months after PTA for failed AVF is only 51.7%. 3 To address this low patency rate, several new devices, such as cutting balloons, 4 stent-grafts, 5 and drug-coated balloons (DCBs), 6 have been developed. Although AVF stenosis is considered to be caused by intimal hyperplasia (IH), 7 stenosis not associated with IH has also been observed on ultrasound examination.…”

Section: Introductionmentioning

confidence: 99%

Impact of Lesion Morphology on Durability After Angioplasty of Failed Arteriovenous Fistulas in Hemodialysis Patients

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Impact of Lesion Morphology on Durability After Angioplasty of Failed Arteriovenous Fistulas in Hemodialysis Patients

et al. 2017

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“…In the 2019 update of Kidney Disease Outcomes Quality Initiative guidelines for vascular access, endovascular angioplasty (with a high-pressure balloon as needed) was considered a reasonable primary treatment for AVF stenotic lesions with clinical indicators [3]. PTA could immediately restore the flow for hemodialysis while conserving vascular resource for patients, but the high restenosis and reintervention rate remains a significant challenge [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Morphological Lesion Types Are Associated with Primary and Secondary Patency Rates after High-Pressure Balloon Angioplasty for Dysfunctional Arteriovenous Fistulas

et al. 2021

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Background: Neointimal hyperplasia (NIH) is believed to be the main reason for arteriovenous fistula (AVF) dysfunction, but other mechanisms are also recognized to be involved in the pathophysiological process. This study investigated whether different morphological types of AVF lesions are associated with the patency rate after percutaneous transluminal angioplasty (PTA). Methods: This retrospective study included 120 patients who underwent PTA for autogenous AVF dysfunction. All the cases were evaluated under Doppler ultrasound (DU) before intervention and divided into 3 types: Type I (NIH type), Type II (non-NIH type), and Type III (mixed type). Prognostic and clinical data were analyzed by Kaplan-Meier analysis and the Cox proportional hazards model. Results: There was no statistical difference in baseline variables among groups, except for lumen diameter. The primary patency rates in Type I, Type II, and Type III groups were 78.4, 93.2, and 83.2% at 6 months and 59.5, 84.7, and 75.5% at 1 year, respectively. The secondary patency rates in Type I, Type II, and Type III groups were 94.4, 97.1, and 100% at 6 months and 90.5, 97.1, and 94.7% at 1 year, respectively. The Kaplan-Meier curve showed that the primary and secondary patency rates of Type I group were lower than those of Type II group. Multivariable Cox regression analysis demonstrated that postoperative primary patency was correlated with end-to-end anastomosis (hazard ratio [HR] = 2.997, p = 0.008, 95% confidence interval [CI]: 1.328–6.764) and Type I lesion (HR = 5.395, p = 0.004, 95% CI: 1.730–16.824). Conclusions: NIH-dominant lesions of AVF evaluated by DU preoperatively were a risk factor for poor primary and secondary patency rate after PTA in hemodialysis patients.

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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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Percutaneous Transluminal Angioplasty in Japan: Five-Center Investigation

Abstract: The clinical success rate of PTA in five centers was relatively high and a major complication rate was only 0.17%. However, anatomical success rates were low comparing with the previous studies and the primary patency rates were inferior to the past data.

Cited by 10 publications

References 21 publications

Impact of Lesion Morphology on Durability After Angioplasty of Failed Arteriovenous Fistulas in Hemodialysis Patients

Impact of Lesion Morphology on Durability After Angioplasty of Failed Arteriovenous Fistulas in Hemodialysis Patients

Morphological Lesion Types Are Associated with Primary and Secondary Patency Rates after High-Pressure Balloon Angioplasty for Dysfunctional Arteriovenous Fistulas

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

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