[Radiologic recanalization of veins, vascular prostheses and arteries in cases of insufficient dialysis fistulas].

Two hundred and sixty-five radiological recanalisations have been carried out in 196 patients with stenoses or occlusions of haemodialysis shunts (167 Cimino shunts, 29 prosthetic shunts). Balloon dilatation was successful in 93% (144 out of 155) stenoses of the shunt vein; redilatation was occasionally necessary, but at six, 12 and 24 months, the patency rate was 75% (56/75), 62% (40/64) and 34% (19/55). Eighty occlusions of shunt veins or prosthetic shunts in 71 patients were treated by a combination of a local fibrinolysis and balloon dilatation or by balloon dilatation alone. Primary recanalisation rate was 56% (14/25) and 65% (36/55), respectively; the six, 12 and 24 months patency rates were 73% (22/30), 54% (7/13) and 14% (1/7). All six recanalisations of the shunt artery--five stenoses and one occlusion--proved successful. In 19 patients with oedema of the arm, 30 dilatations of central veins were performed (18 stenoses, one occlusion). The recanalisation rate was 97% (29/30), the six months patency rate was 57% (8/14). The long-term results of radiological recanalisation are comparable with surgical revision by patch plasty or thrombectomy, but the radiological techniques are simpler, can be carried out on out patients and can be repeated if necessary.