Treatment of failed native arteriovenous fistulae for hemodialysis by interventional radiology

Turmel-Rodrigues, Luc; Pengloan, J; Rodrigue, Hervé; Brillet, Georges; Lataste, A.; Pierre, Dominique; Jourdan, Jean-Louis; Blanchard, Didier

doi:10.1046/j.1523-1755.2000.00940.x

Cited by 181 publications

(125 citation statements)

References 23 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…In other studies, urokinase or r-tPA (recombinant tissue plasminogen activator) were used in combination with PTA. The treatment results were similar to those presented in the studies where only PTA was used: PP 18-70%, SP -63-81% [20][21][22][23]. Vascular access through femoral artery and the use of long sheaths to manage AVF may not be widely utilized, but has clear advantages.…”

Section: Pawel Maga Et Al Endovascular Treatment Of Arteriovenous Fsupporting

confidence: 71%

Endovascular treatment of dysfunctional arteriovenous fistula in hemodialyzed patients — the results of one year follow-up

Maga

Krzanowski²,

Kaczmarczyk³

et al. 2017

Acta Angiologica

View full text Add to dashboard Cite

show abstract

Section: Pawel Maga Et Al Endovascular Treatment Of Arteriovenous Fsupporting

confidence: 71%

Endovascular treatment of dysfunctional arteriovenous fistula in hemodialyzed patients — the results of one year follow-up

Maga

Krzanowski²,

Kaczmarczyk³

et al. 2017

Acta Angiologica

View full text Add to dashboard Cite

show abstract

“…Although screening for AR can detect stenosis, its performance is inferior to that of Qa in AV fistulae (16). Avoiding the use of any screening strategy and performing angioplasty only for thrombosis or clinically evident stenosis is associated with significantly lower patency rates (50 to 70% at 12 mo) (17,18). In addition, angioplasty of subclinical stenosis is associated with improved dialysis delivery (1); therefore, this expectant strategy might result in morbidity due to under-dialysis.…”

Section: Discussionmentioning

confidence: 99%

Access Flow Monitoring of Patients with Native Vessel Arteriovenous Fistulae and Previous Angioplasty

Tonelli¹,

Hirsch²,

Clark

et al. 2002

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Abstract. Screening strategies based on measurement of access blood flow (Qa) allow detection and angioplasty of subclinical stenosis in native vessel arteriovenous (AV) fistulae. However, little is known about the efficacy of Qa measurements for detecting recurrent stenoses in fistulae and that of angioplasty for correcting them. A total of 303 patients were studied over 30 mo; 69 (23%) of these had stenoses, of whom 53 underwent angioplasty. Of those undergoing angioplasty, 30 patients had 46 episodes of recurrent positive studies and underwent repeat fistulography. In 31 of these episodes (19 patients), stenosis was again identified and treated successfully with angioplasty. Overall positive predictive values for stenosis were similar in first and subsequent episodes of stenosis (71% versus 67%), and angioplasty was associated with sustained increases in Qa for both first and subsequent episodes. Assisted patency in fistulae that required repeat angioplasty was 87% (median follow-up 10 mo after the second angioplasty). In conclusion, Qa is effective for detecting first and subsequent lesions in patients with AV fistulae, and angioplasty of first or subsequent lesions is associated with sustained increments in Qa. Continued screening after correction of first stenoses appears reasonable, because of both the frequency of recurrent stenosis and the success of repeat intervention.Ultrasound dilution measurement of access blood flow (Qa) has been shown to accurately identify first episodes of subclinical stenosis in native vessel fistulae (1). Most such stenoses, once identified, are amenable to percutaneous angioplasty, which is associated with short-term improvements in Qa and dialysis delivery. Although access screening programs have been shown to prolong the use-life of polytetrafluoroethylene (PTFE) grafts (2) and cohorts of mixed access type (3), little data exists on the effect of such programs on native arteriovenous dialysis fistulae (4 -6).The diagnostic performance of Qa in native vessel fistulae that have previously undergone angioplasty for stenosis is unknown. The positive predictive value of screening might differ substantially in this population compared with unselected fistulae, both because of the prevalence of stenosis and because of mechanical effects of angioplasty on the native vessel conduit. Finally, the effectiveness of angioplasty for correcting recurrent stenoses in fistulae is unclear. These data will become increasingly relevant as access screening programs are implemented in more dialysis centers and the prevalence of fistulae with previously angioplastied stenosis increases.There were two objectives for the current study. The first was to determine the positive predictive value of ultrasound dilution techniques (UDT) for the detection of subclinical stenoses in fistulae that have previously undergone angioplasty. The second was to document the efficacy of angioplasty at correcting stenoses in fistulae that have previously undergone angioplasty. In both cases, results from those with ...

show abstract

“…However, in case of thrombosis, venous fistulas are more difficult to treat and patency at short-term follow-up is unsatisfactory. 6,7 Open surgical repair or endovascular treatment has been proposed. As recommended by the clinical practice guidelines of the National Kidney Foundation (NKF)-Kidney Disease Outcomes Quality Initiative (KDOQI), each institution …”

Section: Discussionmentioning

confidence: 99%

“…With the use of manual catheter aspiration, 73 hemodialysis accesses were treated by Turmel-Rodrigues et al 7 reporting a primary patency rate of 9% at 12 months when the fistulas were localized at the arm and 49% when localized at the forearm. Secondary patency rates at 12 months were 50% and 81%, respectively.…”

mentioning

confidence: 99%

Stent tunnel technique to save thrombosed native hemodialysis fistula with extensive venous aneurysm

Rabellino¹,

Rosa-Díez

Shinzato³

et al. 2017

IJNRD

View full text Add to dashboard Cite

Introduction and purpose:The increasing number of patients undergoing hemodialysis and the limited number of access sites have resulted in an increasing number of techniques to maintain vascular access for hemodialysis. Thrombosed arteriovenous (AV) fistulas with large venous aneurysms have poor treatment results, with both endovascular and surgical techniques, leading to a high rate of definitive AV access loss. The purpose of this study was to review the feasibility and initial results of this novel endovascular treatment of thrombosed AV fistulas with large venous aneurysms. Materials and methods: A novel endovascular treatment technique of inserting nitinol autoexpandable uncovered stents stretching through the whole puncture site area, thus creating a tunnel inside the thrombus, was retrospectively analyzed and described. Results: A total of 17 stents were placed in 10 hemodialysis fistulas, with a mean venous coverage length of 17.8 cm. In all the cases, 100% technical success was achieved, with complete restoration of blood flow in all patients. There were no procedure-related complications. The mean follow-up was 167 days (range 60-420 days), with a primary and assisted patency of 80% and 100%, respectively. No multiple trans-stent struts-related complications were observed. Three stent fractures were diagnosed with plain films at the site of puncture without consequence in the venous access permeability. Conclusion: The "stent tunnel technique" is a feasible, safe and effective alternative to salvage native hemodialysis access, thus extending the function of the venous access with no signs of stent-related complications and a respectable midterm patency.

show abstract

Treatment of failed native arteriovenous fistulae for hemodialysis by interventional radiology

Cited by 181 publications

References 23 publications

Endovascular treatment of dysfunctional arteriovenous fistula in hemodialyzed patients — the results of one year follow-up

Endovascular treatment of dysfunctional arteriovenous fistula in hemodialyzed patients — the results of one year follow-up

Access Flow Monitoring of Patients with Native Vessel Arteriovenous Fistulae and Previous Angioplasty

Stent tunnel technique to save thrombosed native hemodialysis fistula with extensive venous aneurysm

Contact Info

Product

Resources

About