Predictors of arteriovenous graft patency after radiologic intervention in hemodialysis patients

Lilly, Regina Z.; Carlton, Donna; Barker, Jill; Saddekni, Souheil; Hamrick, Kay; Oser, Rachel; Westfall, Andrew O.; Allon, Michael

doi:10.1016/s0272-6386(05)80010-1

Cited by 101 publications

(86 citation statements)

References 26 publications

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“…Detailed evidence-supported guidelines have been developed regarding vascular access placement (1)(2)(3)(4), and much has been written about the surveillance, maintenance, biology, cost, and interventional techniques for these accesses (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Similarly, predictors of success following radiological intervention of these access sites have been evaluated, including pressure, the degree of stenosis, and procedure type (16,17). Patient age, access site, underlying comorbidities, the serum albumin level, and systemic systolic pressure over time have been evaluated as potential predictors of graft patency following intervention (16,18).…”

Section: Resultsmentioning

confidence: 99%

“…Similarly, predictors of success following radiological intervention of these access sites have been evaluated, including pressure, the degree of stenosis, and procedure type (16,17). Patient age, access site, underlying comorbidities, the serum albumin level, and systemic systolic pressure over time have been evaluated as potential predictors of graft patency following intervention (16,18). Nevertheless, the optimal timing of intervention for thrombosed dialysis access remains unknown.…”

Section: Resultsmentioning

confidence: 99%

“…Allon et al (23) reported dramatic improvement in the maintenance of AV grafts in their dialysis population on implementation of a multidisciplinary approach that involved the transition of procedures to an outpatient setting, aggressive surveillance, and detailed logistical support. The potential relationships of numerous variables to patency over time have been evaluated for graft access procedures (12,14,16,18,22,23) and several studies have addressed parameters for preventing thrombosis (5)(6)(7)15). However, to the best of our knowledge, no study has addressed the effect of the time interval/delay from clinical presentation of a thrombosis to the procedure on intervention success.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously

Prologo¹,

Minwell

Kent

et al. 2014

Diagn Interv Radiol

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously

Prologo¹,

Minwell

Kent

et al. 2014

Diagn Interv Radiol

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“…If the AV graft was thrombosed, thrombolysis using urokinase and/or mechanical thrombolysis were used for declotting without fistulography (7).…”

Section: Procedures and Techniquesmentioning

confidence: 99%

“…They evaluated outcomes of percutaneous declotting procedures in patients with prosthetic femoral dialysis grafts. In 2001, Regina et al (7) reported clinical and radiologic predictors of prosthetic AV grafts after PTA in 500 patients. However, their study was limited by the inability to classify the location of grafts in the upper or lower extremities.…”

mentioning

confidence: 99%

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Kim²,

Goo³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the safety and effectiveness of percutaneous transluminal angioplasty (PTA) for dysfunctional femoral arteriovenous graft and analyze clinical or anatomic predictors of graft patency. METHODSThe records of 45 patients who underwent PTA or thromboaspiration for dysfunctional or thrombosed femoral arteriovenous graft from 2005 to 2012 were reviewed retrospectively. Primary and secondary patency rates were determined at three, six, and 12 months after PTA. The primary patency rate was analyzed according to the presence of diabetes mellitus, graft age from the time of creation to the first intervention (<12 months or ≥12 months), presence of thrombus, shape of graft (U-shape vs. straight-shape), anastomosis type of graft (femoral-femoral vs. femoral-saphenous), location of stenosis (central vs. peripheral), length of stenosis (<2 cm vs. ≥2 cm), degree of stenosis severity (<70% vs. ≥70%), and stent insertion. RESULTSA total of 124 PTAs were performed in 45 patients. The primary patency rate at three, six, and 12 months was 84.8%, 63.6%, and 24.2%, respectively. The secondary patency rate at three, six, and 12 months was 95.2%, 95.2%, and 85.7%, respectively. The mean duration of primary and secondary patency was 13.2 and 35.7 months, respectively. No significant clinical or anatomical predictors of primary patency could be identified. Stent placement had a negative effect on primary patency. CONCLUSION PTA is a safe and effective treatment for dysfunctional femoral arteriovenous grafts. Stent placement seems to improve technical success, but does not enhance the primary patency rate of dysfunctional femoral arteriovenous grafts.

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Prospective assessment of hemodialysis access patency after percutaneous intervention: Cox proportional hazards analysis

Bittl

Feldman

2005

Cathet Cardio Intervent

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Vascular access failure is the greatest limitation of successful hemodialysis, but the factors associated with long-term patency have not been fully elucidated. Outcomes in a consecutive series of 294 thrombosed or failing accesses [128 fistulas (43.5%) and 166 grafts (56.5%) in 179 patients] were analyzed with life table and multivariable Cox proportional hazards analysis. Initial success was achieved in 275 of 294 accesses (95.6%). The median patency after intervention was 206 days (interquartile range, 79-457 days). Fistulas had longer median patency after intervention than grafts (286 vs. 170 days). Nonthrombosed accesses had longer median patency than thrombosed accesses (238 vs. 136 days), but thrombosed fistulas had similar median patency as thrombosed grafts (140 vs. 136 days). The selective use of stents as a bailout for failed balloon dilatation did not significantly reduce long-term patency (196 days for stented accesses vs. 210 days for unstented accesses). Long-term patency was inversely related to final access pressure, but access patency was not related to the presence of central venous occlusions, graft age, patient age, sex, or diabetes. Catheter-based intervention of thrombosed and failing dialysis accesses significantly prolongs patency and usefulness of dialysis accesses. The expanding use of fistulas, improved detection of early access failure, and selective use of bailout stents should enhance long-term access patency.

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Predictors of arteriovenous graft patency after radiologic intervention in hemodialysis patients

Cited by 101 publications

References 26 publications

Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously

Effect of the time to intervention on the outcome of thrombosed dialysis access grafts managed percutaneously

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Prospective assessment of hemodialysis access patency after percutaneous intervention: Cox proportional hazards analysis

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