Gianturco self-expanding stent in the treatment of stenosis in dialysis access grafts.

This study evaluated the effectiveness of the Gianturco endovascular stent in preserving graft patency following percutaneous transvenous angioplasty (PTVA) of stenotic lesions occurring at the graft-vein anastomosis in hemodialysis patients with polytetrafluoroethylene grafts. Fifty-eight patients having 50% or greater stenosis were randomly divided into a treatment group (N = 28) and a concurrent control group (N = 30) following PTVA. In the treatment group, a stent was placed following dilatation. Graft thrombosis, the need for surgical revision, or the need for a repeat PTVA were used as end point events. The period of time from the PTVA/stent procedure to the end point event was referred to as the duration of efficacy (DE). By life table analysis, the DE for the treatment group was 100% at 30 days, 91% at 60 days, 85% at 90 days, 72% at 180 days, and 17% at 360 days. Comparison of the characteristics and results obtained in the treatment group and that of the concurrent control group revealed no significant difference in any parameter prior to treatment, in the response to PTVA, or in the DE of the procedure performed. It was concluded that the stent offered no advantage in the treatment of the graft-vein anastomosis stenotic lesion affecting PTFE dialysis access grafts.

RCT Entities:   Population Interventions Outcomes