Factors Associated with Secondary Functional Patency After Percutaneous Transluminal Angioplasty of the Early Failing or Immature Hemodialysis Arteriovenous Fistula

Higashiura, Wataru; Takara, Hiroaki; Kitamura, Ryoichi; Yasutani, Tadashi; Miyasato, Hitoshi; Tengan, Toshiho

doi:10.1007/s00270-018-2083-0

Cited by 7 publications

(9 citation statements)

References 19 publications

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“…The medium patency duration of AVFs and AVGs after PTA in the present study was 11±0.71 months, which is comparable to the duration of 8-13 months reported in the literature (8). The postintervention primary and secondary patency rates at 12 months were 44.0% and 89.6%, respectively, which is also consistent with the rates in previous studies (8,12,13). Owing to economic and local medical conditions, some patients gave up the repairable AVF or AVG, and chose a new fistula or central venous catheter instead of a PTA according to our follow-up.…”

Section: Multivariate Analysissupporting

confidence: 91%

“…Multivariate analysis revealed the stenosis length longer than 2 cm predicted poorer patency of AVF after PTA, which is consistent with the most recent literature (13,24,25,31). A study by Higashiura et al suggested that longer lesion length was an important predictor of postintervention patency of both late and early dysfunctional AVF (12). Neuen et al's study indicated that the influence of stenosis length on postintervention patency was related to the location of the stenosis.…”

Section: Multivariate Analysissupporting

confidence: 80%

“…Owing to economic and local medical conditions, some patients gave up the repairable AVF or AVG, and chose a new fistula or central venous catheter instead of a PTA according to our follow-up. Several studies have reported on the predictors of primary and secondary patency, but the results were inconsistent as there was no well-defined criteria for the abandonment of VA (11,12). Compared to AVG, dramatically higher postintervention patency of AVF was found in this study, in agreement with previous studies (18,19).…”

Section: Multivariate Analysissupporting

confidence: 74%

“…Neuen et al reported that the patency rate was lower for VA younger than 6 months compared with those older than 6 months (11), and Heye et al showed that restenosis occurred earlier in AVF created less than 1 year compared with those at least 1 year old (8). Furthermore, Higashiura et al found that the patency rate of non-maturing fistulas (younger than 3 months) was worse than mature fistulas (12). In Neuen et al's opinion, fistulas with early stenosis were likely to be intrinsically faulty and had a tendency to form neointimal hyperplasia (23).…”

Section: Multivariate Analysismentioning

confidence: 99%

“…The durability of PTA is limited, with a 12-month postintervention patency rate ranging between 26-64% (8,9). Variables that can affect patency after PTA have been studied in several previous reports, including clinical, anatomical, technical, and biochemical factors, however, conclusions were inconsistent or even contradictory (6,(10)(11)(12). Furthermore, there have been few reports on the factors influencing restenosis of AVF and AVG respectively.…”

Section: Introductionmentioning

confidence: 99%

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Predictors associated with early and late restenosis of arteriovenous fistulas and grafts after percutaneous transluminal angiography

Zheng¹,

Xie²,

Xie³

et al. 2021

Ann Transl Med

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Background: The objective of this study was to assess postintervention patency and analyze the predictive factors associated with early and late restenosis after intervention in hemodialysis arteriovenous fistulas (AVF) and arteriovenous grafts (AVG).Methods: This study retrospectively analyzed 284 hemodialysis patients who underwent percutaneous transluminal angioplasty (PTA) due to AVF and AVG stenosis. A total of 350 PTA procedures were performed. Clinical, anatomical, biochemical, and technical variables were analyzed. Using univariate and multivariate analyses, we assessed the postintervention patency of PTA by follow-up, and identified the predictive factors taking into account competing risks.Results: Postintervention patency rates at 3, 6, 12, and 24 months were 86.5%, 66.4%, 42.6%, and 29.8%, respectively, with a median patency duration of 11±0.71 months. Kaplan-Meier analysis showed that the patency rate of the AVF group (n=271) was dramatically higher than the AVG group (n=79) at 3, 6, and 12 months after PTA, respectively (88.9% vs. 78.5%, 69.0% vs. 57.4%, 48.8% vs. 20.0%, P<0.01). Cox survival analysis revealed that the factors associated with postintervention patency of AVF included age of fistulas, serum albumin (ALB) levels, location of stenoses, lesion length longer than 2 cm, multiple stenoses, and maximal pressure of dilatation lower than 16 atm. In addition, factors related to postintervention patency of AVG included the presence of diabetes and hypertension, and serum ALB.Conclusions: This study demonstrated that the risk factors associated with postintervention patency of AVF included age of fistulas, lower levels of serum ALB, location of stenoses, lesion length longer than 2 cm, multiple stenoses, and maximal pressure of dilatation lower than 16 atm. In addition, risk factors related to postintervention patency of AVG included the presence of diabetes and lower levels of serum ALB, while the presence of hypertension was found to be a protective factor for reducing patency loss of AVG. Among all these factors, serum ALB and multiple stenoses tended to predict early restenosis, while pressure of dilatation tended to predict late restenosis.

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