PURPOSE: To report the usefulness of percutaneous transluminal angioplasty (PTA) of a non-mainstream venous route in an occluded native hemodialysis fistula when a mainstream outflow vein could not be traversed. MATERIALS AND METHODS: This cohort included seven patients with an occulted hemodialysis fistula with difficulty in traversing via a mainstream route. A non-mainstream vein near the occluded portion was traversed until it connected with a proximal large-sized vein and the route was dilated using a 4- or 5-mm balloon catheter. Metallic stent placement was performed, if necessary. Technical aspects and long-term patency was evaluated. RESULTS: PTA could be performed in all patients; however, stent placement was required in two because of residual stenosis and clotting. The clinical success rate of fistula restoration was 100 %. Fistula dysfunction recurred in six patients 17-668 days (mean ± standard deviation 229.3 ± 225.0) later. PTA was repeated in four patients, but not in two. The mean duration of the primary patency was 336.6 ± 417.2 days (range 17-1,190) and that of the secondary patency was 897.1 ± 801.4 days (range 17-2,230). CONCLUSION: PTA of a non-mainstream venous route is useful for restoring an occluded hemodialysis fistula when the mainstream outflow vein cannot be traversed.
PURPOSE: To report the usefulness of percutaneous transluminal angioplasty (PTA) of a non-mainstream venous route in an occluded native hemodialysis fistula when a mainstream outflow vein could not be traversed. MATERIALS AND METHODS: This cohort included seven patients with an occulted hemodialysis fistula with difficulty in traversing via a mainstream route. A non-mainstream vein near the occluded portion was traversed until it connected with a proximal large-sized vein and the route was dilated using a 4- or 5-mm balloon catheter. Metallic stent placement was performed, if necessary. Technical aspects and long-term patency was evaluated. RESULTS: PTA could be performed in all patients; however, stent placement was required in two because of residual stenosis and clotting. The clinical success rate of fistula restoration was 100 %. Fistula dysfunction recurred in six patients 17-668 days (mean ± standard deviation 229.3 ± 225.0) later. PTA was repeated in four patients, but not in two. The mean duration of the primary patency was 336.6 ± 417.2 days (range 17-1,190) and that of the secondary patency was 897.1 ± 801.4 days (range 17-2,230). CONCLUSION: PTA of a non-mainstream venous route is useful for restoring an occluded hemodialysis fistula when the mainstream outflow vein cannot be traversed.
Authors: L Turmel-Rodrigues; A Mouton; B Birmelé; L Billaux; N Ammar; O Grézard; S Hauss; J Pengloan Journal: Nephrol Dial Transplant Date: 2001-12 Impact factor: 5.992
Authors: L Turmel-Rodrigues; M Sapoval; J Pengloan; L Billaux; D Testou; S Hauss; A Mouton; D Blanchard Journal: J Vasc Interv Radiol Date: 1997 Sep-Oct Impact factor: 3.464
Authors: Timothy W I Clark; Raphael A Cohen; Andrew Kwak; James F Markmann; S William Stavropoulos; Aalpen A Patel; Michael C Soulen; Jeffrey I Mondschein; Sidney Kobrin; Richard D Shlansky-Goldberg; Scott O Trerotola Journal: Radiology Date: 2006-11-07 Impact factor: 11.105