Korean Circulation Journal

  • 제41권9호
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  • Pages.512-517
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  • 2011
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

The Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Patients With Vascular Access Failure

  • Kim, Woo-Shin (Division of Cardiology, Department of Internal Medicin, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Pyun, Wook-Bum (Division of Cardiology, Department of Internal Medicin, Mokdong Hospital, School of Medicine, Ewha Womans University) ;
  • Kang, Byung-Chul (Department of Radiology, Mokdong Hospital, School of Medicine, Ewha Womans University)
  • 발행 : 2011.09.30
⟨ 이전 논문 다음 논문 ⟩

초록

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${\pm}$12.9 years. We performed 122 interventions in 53 AVG patients (44.9%), and 109 interventions in 65 AVF patients (55.1%). If there was thrombosis of the vascular access, urokinase was administered and/ or thrombus aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. Results: For the 118 patients, the median patency time was 10.45${\pm}$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.

키워드

참고문헌

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  8. Outcome of Percutaneous Intervention in Dysfunctional Loop versus Straight Arteriovenous Grafts in Hemodialysis Patients vol.104, pp.1, 2011, https://doi.org/10.5334/jbsr.2146
  9. Dialysis Shunt Thrombectomy Utilizing a Rotational Thrombectomy Device in Patients with Pseudoaneurysms vol.4, pp.2, 2020, https://doi.org/10.4103/ajir.ajir_8_20
  10. Efficacy of ultrasound-guided percutaneous transluminal angioplasty for arteriovenous fistula stenosis or occlusion at juxta-anastomosis: A 3-year follow-up cohort study vol.74, pp.1, 2011, https://doi.org/10.1016/j.jvs.2020.11.041