PURPOSE: To determine the clinical effectiveness of stent-graft placement in dysfunctional autogenous hemodialysis fistulas. MATERIALS AND METHODS: Between September 2006 and June 2008, 24 Fluency Plus stent-grafts were inserted in 17 patients with failing autogenous hemodialysis fistulas (two radiocephalic, 12 brachiocephalic, and three brachiobasilic). Six fistulas were thrombosed at presentation. Indications for stent-graft insertion included 10 residual stenoses, six pseudoaneurysms, and one fistuloplasty-induced rupture. Fistula function before and after intervention was assessed with ultrasound dilution technique. RESULTS: The technical success rate was 100%, as were the anatomic and clinical success rates. Via Kaplan-Meier method, the primary access patency rates were 94.1% at 3 months (95% CI, 0.461-0.995) and 88.2% at 6 and 12 months (95% CI, 0.468-0.980). The primary lesion patency rate was 94.1% (95% CI, 0.650-0.992) at 3, 6, and 12 months. The secondary access patency rate had a point estimate of 100% at 3 months, and was 93.8% (95% CI, 0.632-0.991) at 6 and 12 months. Univariate analysis suggested that male sex and left-sided accesses were associated with a longer primary access patency rate (P = .02). The binary restenosis rate at 6 months was 5.9%. Mean transonic flow rates were 667.5 mL/min before intervention and 2,076.0 mL/min after intervention (P = .03, Wilcoxon signed-rank test). No patients were lost to follow-up. CONCLUSIONS: Stent-graft placement in dysfunctional autogenous hemodialysis fistulas is technically feasible and effective in preserving function and preventing access abandonment, with patency rates that exceed historical patency rates with angioplasty and/or uncovered stents. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
PURPOSE: To determine the clinical effectiveness of stent-graft placement in dysfunctional autogenous hemodialysis fistulas. MATERIALS AND METHODS: Between September 2006 and June 2008, 24 Fluency Plus stent-grafts were inserted in 17 patients with failing autogenous hemodialysis fistulas (two radiocephalic, 12 brachiocephalic, and three brachiobasilic). Six fistulas were thrombosed at presentation. Indications for stent-graft insertion included 10 residual stenoses, six pseudoaneurysms, and one fistuloplasty-induced rupture. Fistula function before and after intervention was assessed with ultrasound dilution technique. RESULTS: The technical success rate was 100%, as were the anatomic and clinical success rates. Via Kaplan-Meier method, the primary access patency rates were 94.1% at 3 months (95% CI, 0.461-0.995) and 88.2% at 6 and 12 months (95% CI, 0.468-0.980). The primary lesion patency rate was 94.1% (95% CI, 0.650-0.992) at 3, 6, and 12 months. The secondary access patency rate had a point estimate of 100% at 3 months, and was 93.8% (95% CI, 0.632-0.991) at 6 and 12 months. Univariate analysis suggested that male sex and left-sided accesses were associated with a longer primary access patency rate (P = .02). The binary restenosis rate at 6 months was 5.9%. Mean transonic flow rates were 667.5 mL/min before intervention and 2,076.0 mL/min after intervention (P = .03, Wilcoxon signed-rank test). No patients were lost to follow-up. CONCLUSIONS: Stent-graft placement in dysfunctional autogenous hemodialysis fistulas is technically feasible and effective in preserving function and preventing access abandonment, with patency rates that exceed historical patency rates with angioplasty and/or uncovered stents. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
Authors: Riccardo Corti; Pietro Quaretti; Franco Galli; Lorenzo Paolo Moramarco; Nicola Cionfoli; Giovanni Leati; Riccardo Corbetta; Matteo Tozzi Journal: SAGE Open Med Case Rep Date: 2017-11-14
Authors: José García-Medina; Ana B Maldonado-Cárceles; Juan J García-Alfonso; Julián J Árense-Gonzalo; Alberto M Torres-Cantero Journal: Clin Kidney J Date: 2020-02-10
Authors: Soo Buem Cho; Ho Cheol Choi; EunJin Bae; Tae Jin Park; Hye Jin Baek; Sung Eun Park; Kyeong Hwa Ryu; Jin Il Moon; Bo Hwa Choi; Kyungsoo Bae; Kyung Nyeo Jeon Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817