Percutaneous Treatment of Thrombosed Hemodialysis Arteriovenous Fistulas: Use of  Thromboaspiration and Balloon Angioplasty

Cildag, Burak; Köseoğlu, Kutsi

doi:10.15386/cjmed-686

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…In patients with associated thrombosis, success rates in the published literature range from 60% to 100%. [ 15 16 ] For thromboaspiration, Çildağ et al [ 11 ] reported a technical success rate of 83%, comparable to the results of present study (84.2%, n = 16).…”

Section: Discussionsupporting

confidence: 88%

“…The demographic profile of the study group showed male predominance (n = 29, 63.04%), with the most common decade of presentation being the sixth decade. [ 9 11 12 ] There was high prevalence of hypertension and diabetes in the study group, similar to the results of Al Gaby et al [ 12 ] and Hendawy et al . [ 4 ] This is compatible with the fact that diabetic nephropathy is the most common cause of chronic renal disease in the Indian population.…”

Section: Discussionsupporting

confidence: 87%

“…Çildağ et al . [ 11 ] reported that post thromboaspiration, primary patency rates were as low as 55% at 3 months. In a multicenter prospective trial by Huijbregts HJ et al .,[ 20 ] PIPP and PIAPP at the end of 3 months were documented as 83% and 92%, respectively; however, their study population had a more homogenous profile of dysfunctional fistulas.…”

Section: Discussionmentioning

confidence: 99%

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Role of endovascular treatment in dysfunctional hemodialysis fistulae: A single center experience

Arora¹,

Thakker²,

Sarda³

et al. 2022

Indian J Nephrol

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Introduction: Arteriovenous fistulas (AVFs) are the preferred route of hemodialysis in end-stage renal disease. However, recurrent patency loss is an obstacle in long-term maintenance. Endovascular treatments may provide a durable option for prolongation of patency in AVFs. Methods: Retrospective observational study was done on 46 patients with AVF for hemodialysis in the Department of Diagnostic and Interventional Radiology for a period of 1 year from September 2020 to August 2021. The characters of dysfunctional fistulas and results of various interventional procedures were assessed for technical and clinical success rates. Short-term follow-up records of patients were assessed for post-intervention primary patency (PIPP) and post-intervention assisted primary patency (PIAPP) of various procedures. Results: The most successful outcomes post intervention were seen in radio-cephalic fistulas formed more than 1 year ago with juxta-anastomotic narrowing. The overall technical success rate was 89.13% with a PIPP of 78.26% and a PIAPP of 82.60% at 3 months. PTA had better technical success rates (88.23%) as compared to dysfunctional segments with thrombosis that underwent angioplasty and thromboaspiration (84.2%). Central venous stenosis undergoing PTA and stenting had a 100% success rate. At 3 months follow-up, PIPP was better among the angioplasty plus thromboaspiration group (73.7%), while PIAPP rate was better in the angioplasty subgroup at 82.35%. Conclusion: Endovascular intervention is the first-line treatment in dysfunctional AVFs attributable to the multitude of options available, all of which have comparable outcomes, high success rates, and notable short-term patency.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of endovascular treatment in dysfunctional hemodialysis fistulae: A single center experience

Arora¹,

Thakker²,

Sarda³

et al. 2022

Indian J Nephrol

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“…Our study achieved a primary patency rate of 76.7% and a secondary patency rate of 93.3%, which was similar to or better than other reports in the literature. For example, Cildag et al evaluated thrombus aspiration followed by PTA, which achieved a technical success rate of 83% and primary and secondary patency rates of 40% to 55% at 6 and 12 months [15]. Kim et al used mechanical thrombectomy followed by PTA and reported a primary patency rate of 63% at 6 months [16].…”

Section: Discussionmentioning

confidence: 99%

“…Angioplasty alone can adequately restore the patency of a stenosed AVF [14], but the fistula thrombus must be treated first. Therefore, combining thrombus management and angioplasty may be effective for acutely thrombosed AVFs [15,16].…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Thrombolysis with Percutaneous Transluminal Angioplasty Using a Trans-Brachial Approach to Treat Thrombosed Arteriovenous Fistulas

Wang

et al. 2019

Med Sci Monit

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Background Arteriovenous fistulas (AVFs) are used to provide vascular access for hemodialysis in patients with end-stage renal failure. However, stenosis and thrombosis can compromise long-term AVF patency. The objective of this study was to evaluate catheter thrombolysis with percutaneous transluminal angioplasty (PTA), using a trans-brachial approach, for acutely thrombosed AVFs. Material/Methods This retrospective study examined 30 cases of AVF thrombosis treated between January 1, 2015 and January 1, 2017. All patients received transcatheter thrombolysis with PTA using a trans-brachial approach. AVF patency was assessed after 6 months. Results Thrombolysis with PTA was performed at 2 to 72 h after diagnosis of AVF occlusion due to acute thrombosis, and AVF patency was restored in all patients. After 6 months, the primary and secondary patency rates were 76.7% and 93.3%, respectively. For type I stenosis, primary patency was achieved in 10 of 16 patients (62.5%) and secondary patency was achieved in 14 of 16 patients (87.5%). For type II stenosis, primary patency was achieved in 13 of 14 patients (92.9%) and secondary patency was achieved in 14 of 14 patients (100%). Comparing type I and II stenosis, a significant difference was detected in the rates of primary patency (odds ratio=0.909, 95% confidence interval 0.754–1.096, P=0.049), but not secondary patency (P=0.178), after 6 months. Conclusions Our study provides preliminary evidence that catheter-directed thrombolysis with PTA using a trans-brachial approach can achieve high patency rates when used to treat acutely thrombosed AVFs.

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Pulmonary embolism in an ESRD patient following minimal venotomy and milking for salvage of dysfunctional autogenous arteriovenous fistula

Rimal

Karki

Paudel

et al. 2023

Clinical Case Reports

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Percutaneous Treatment of Thrombosed Hemodialysis Arteriovenous Fistulas: Use of Thromboaspiration and Balloon Angioplasty

Cited by 7 publications

References 18 publications

Role of endovascular treatment in dysfunctional hemodialysis fistulae: A single center experience

Role of endovascular treatment in dysfunctional hemodialysis fistulae: A single center experience

Transcatheter Thrombolysis with Percutaneous Transluminal Angioplasty Using a Trans-Brachial Approach to Treat Thrombosed Arteriovenous Fistulas

Pulmonary embolism in an ESRD patient following minimal venotomy and milking for salvage of dysfunctional autogenous arteriovenous fistula

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