[Treatment of stenosed or occluded hemodialysis shunts. Results of percutaneous angioplasty and combined radiologic-surgical therapy].

The results of all recanalisations of stenosed and occluded haemodialysis shunts over a period of three years are reported; there were 112 percutaneous angioplasties and 40 combined radiological-surgical procedures. In 13% of cases a metallic endoprosthesis (wall stent) and in 3% Simpson's atherectomy catheter was used. The functional results were retrospectively evaluated for all 152 interventions which involved 60 orthoptic Brescia-Cimino shunts and 19 PTFE prostheses. In addition, the primary and total functions of the treated shunts were calculated. Cumulative function rate (percentage at a given time of effective shunts) for Brescia-Cimino shunts at one year was 80% and after two years 68.5%; for the PTFE prosthesis the corresponding figures were 83.8 and 75.5% respectively. The average number of interventions per patient was 2.3 with a range of 1-7. Total functional rate of all shunts following the first percutaneous procedure after one year was 78.2%, for combined radiological-surgical procedures for the treatment of acute thromboses it was 68%. Comparison with the results of surgical treatment reported in the literature confirms the effectiveness of percutaneous or combined treatment of stenosed or acutely occluded haemodialysis shunts. The outstanding advantage of radiological intervention is its repeatability.