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The primary patency of percutaneous transluminal angioplasty in hemodialysis patients with vascular access failure

Title
The primary patency of percutaneous transluminal angioplasty in hemodialysis patients with vascular access failure
Authors
Kim W.S.Pyun W.B.Kang B.C.
Ewha Authors
강병철편욱범
SCOPUS Author ID
강병철scopus; 편욱범scopus
Issue Date
2011
Journal Title
Korean Circulation Journal
ISSN
1738-5520JCR Link
Citation
vol. 41, no. 9, pp. 512 - 517
Indexed
SCIE; SCOPUS; KCI scopus
Abstract
Background and Objectives: Dysfunction of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) contributes significantly to morbidity and hospitalization in the dialysis population. We evaluated the primary patency of AVFs following percutaneous transluminal angioplasty (PTA) in haemodialysis patients. Subjects and Methods: We performed 231 interventions in 118 patients with a mean age of 62.1±12.9 years. We performed 122 interventions in 53 AVG patients (44.9%), and 109 interventions in 65 AVF patients (55.1%). If there was thrombosis of the vascular access, urokinase was administered and/or thrombus aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. Results: For the 118 patients, the median patency time was 10.45±10.29 months at 92 months of follow-up. The primary patencies for stenotic AVFs at 6, 12, 24, 36, 48, and 60 months were 63.4%, 41.4%, 17.0%, 9.7%, 7.3%, and 2.4%, respectively. The primary patencies for AVGs at 6, 12, 24, and 36 months were 36.9%, 19.5%, 10.8%, 2.1%, respectively, and were obtained by means of the Kaplan-Meier analysis (log rank=6.42, p<0.05). The median patency time was 11.0 months and 4.45 months in the non-thrombus and thrombus groups, respectively. The complication rate was 1.73% (4/231); two cases of pseudoaneurysms and two cases of extravasation were detected. All therapy failures (5/231) occurred in thrombotic lesions of AVGs and were treated surgically. Conclusion: PTA is an efficacious method for the correction of stenosis of AVFs for hemodialysis, thus prolonging the patency of the fistulas. Copyright © 2011 The Korean Society of Cardiology.
DOI
10.4070/kcj.2011.41.9.512
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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