Balloon angioplasty vs nitinol stent placement in the treatment of venous anastomotic stenoses of hemodialysis grafts after surgical thrombectomy

Kakisis, John D.; Avgerinos, Efthimios D.; Giannakopoulos, Triantafillos G.; Moulakakis, Konstantinos G.; Papapetrou, Anastasios; Liapis, Christos D.

doi:10.1016/j.jvs.2011.08.043

Cited by 40 publications

(32 citation statements)

References 25 publications

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“…All the stents used in the present series were metallic stents, and, like most investigators, we tried to avoid potential overuse of these stents because of their association with questionable long-term patency (24)(25)(26). However, promising results have been recently published with nitinol stents and stent-grafts, not only in the treatment of thrombosed hemodialysis grafts (27), but also in the salvage of angioplasty failures, especially in native AVFs (28). Therefore, a systematic stent treatment of residual stenoses with nitinol stents or stent-grafts might have improved the APP in this particular subgroup.…”

Section: Discussionmentioning

confidence: 98%

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

Mortamais

Papillard

Girouin

et al. 2013

Journal of Vascular and Interventional Radiology

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Section: Discussionmentioning

confidence: 98%

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

Mortamais

Papillard

Girouin

et al. 2013

Journal of Vascular and Interventional Radiology

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“…Kakisis et al examined the use of nitinol stents in the region of venous anastomosis in patients with thrombosed brachio-axillary vascular access grafts after surgical thrombectomy. They observed significantly improved assisted primary and secondary patency rates compared to conventional PTA [82].…”

Section: Insufficient Dialysis Graftmentioning

confidence: 94%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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A wide variety of diagnostic and minimally invasive modalities is currently available to radiologists for providing sufficient medical care for dialysis patients. In addition to clinical examination, ultrasound is the first line imaging method in suspected dialysis vascular access dysfunction. The percutaneous approach is the primarily recommended therapeutic option in many cases. This article reviews the current diagnostic and therapeutic methods in dialysis vascular access insufficiency. Key Points: ??Vascular access dysfunction is often elicited by stenosed vessels, which are regularly associated with concomitant thrombosis. ??Stenoses are commonly observed in the anastomosis, vascular access vein and also in the central venous system. ??Beside the clinical examination, sonography is the diagnostic method of first choice. ??Percutaneous balloon dilatation frequently is the first treatment option. Citation Format: ??Kamper L, Faizy TD, Haage P. Diagnosis and Treatment of Insufficient Dialysis Vascular Access. Fortschr R?ntgenstr 2015; 187: 360???371

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“…Beathard et al, using Gianturco self-expanding bare metal stents to manage the VA stenosis of AVGs, showed no benefit in a randomized case-control study involving 58 patients (3). Since then, nitinol bare metal stents have been used by several groups to manage stenosis of the VA in AVG salvage procedures, with variable success, and most investigators inferred that the stents led to improvement in primary and secondary patency rates (5)(6)(7)(8). However, most of these studies were small, nonrandomized, and retrospective.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Arteriovenous Grafts Following Simultaneous Thrombectomy and Stent Graft Placement Across the Venous Anastomosis

Nassar

Suki

Rhee

et al. 2014

Seminars in Dialysis

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Arteriovenous grafts (AVGs) suffer from high thrombosis rates. It is not known whether placement of stent grafts at the venous anastomosis (VA) of thrombosed AVGs would impact future thrombosis. This is a retrospective study evaluating a group of AVGs that underwent endovascular thrombectomy with placement of a stent graft at their VA. The study period was a minimum of 1 year or until kidney transplantation or death. Primary and secondary AVG patency rates were obtained using Kaplan-Meier survival estimates. Demographic parameters were analyzed using Cox multivariate analysis. The effect of early vs. late first thrombosis was also studied. Sixty-six patients were included in the study. Of these, 53 (80%) experienced ≥1 thrombotic event during the study period. Thrombosis led to AVG loss in 26 (39%). The primary patency was 47%, 35%, and 21% at 3, 6, and 12 months, respectively. The assisted primary patency was 50%, 38%, and 25% at 3, 6, and 12 months, respectively. The secondary patency rate was 85%, 76%, and 72% at 3, 6, and 12 months, respectively. Thus, poor primary patency rates were observed despite stent graft placement at the VA. In addition, early thrombosis following stent graft placement was associated with worse AVG outcomes.

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Balloon angioplasty vs nitinol stent placement in the treatment of venous anastomotic stenoses of hemodialysis grafts after surgical thrombectomy

Abstract: Graft thrombectomy plus angioplasty with self-expanding nitinol stent placement provides significantly higher patency rates compared with thrombectomy plus plain balloon angioplasty of the venous anastomosis.

Cited by 40 publications

References 25 publications

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Outcomes of Arteriovenous Grafts Following Simultaneous Thrombectomy and Stent Graft Placement Across the Venous Anastomosis

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