Primary Balloon Angioplasty or Hydrostatic Dilatation for Arteriovenous Access: Which Technique has Better Outcomes in Poor Caliber Cephalic Veins?

Khan, Kamran Ali; Bedi, Varinder Singh; Yadav, Ajay; Agarwal, Sandeep; Satwik, Ambarish; Prabhu, Manikanda

doi:10.4103/0972-0820.198071

Cited by 4 publications

(13 citation statements)

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“…The average fistula maturation time for patients in the PBA group (34.41 days) was lesser when compared to the HD group (46.18 days) in this study. A similar study by Khan et al 11 also testified that the maturation time was lesser in the PBA group (32.83 days) compared to the HD group (52.53 days). Moreover, the AVF functioning rate in the PBA group (100%) was found to be higher as compared to the HD group (90%), which was similar to this study too, at six months.…”

Section: Discussionmentioning

confidence: 68%

“…Similar studies conducted previously have reported even higher failure with HD and more success with PBA. 11,23 This would indicate that PBA is an effective method when compared to HD of small diameter cephalic veins (≤2 mm) for AVF creation. Although there were no re-interventions in this study, it has been demonstrated that the re-intervention rate is also low with PBA as compared to HD.…”

Section: Discussionmentioning

confidence: 99%

“…14 However, smaller diameter veins result in increased re-intervention rates and fistulae failures. 11 To tackle this issue, an interesting technique has emerged—the ballooning of small cephalic veins before fistula creation. 15 Hence, the present study utilized the same technique of PBA of small cephalic veins (≤2 mm) prior to fistula creation in one group and indicated this to be a more efficient procedure than standard HD in patients who were rejected formerly due to small cephalic veins.…”

Section: Discussionmentioning

confidence: 99%

“…11,14 Brachial artery was the common site to create AVF followed by radial artery, hence the same was dissected and anastomosed with the cephalic vein in this study to create AVF. 11,14…”

Section: Discussionmentioning

confidence: 99%

“…Although there were no re-interventions in this study, it has been demonstrated that the re-intervention rate is also low with PBA as compared to HD. 11…”

Section: Discussionmentioning

confidence: 99%

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Balloon angioplasty: A promising adjunct to arteriovenous fistula creation compared with hydrostatic dilatation in small-caliber cephalic veins

Tiwari

Basavanthappa

Anandasu

et al. 2021

Asian Cardiovasc Thorac Ann

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Background To maintain the patency and longevity of arteriovenous fistula, the availability of a venous segment with adequate diameter is important. In Indian population, many chronic kidney disease patients have poor caliber veins. The study aimed to evaluate the efficacy of hydrostatic dilatation versus Primary balloon angioplasty of small caliber cephalic veins of (≤2.5 mm) preoperatively in terms of patency rate and maturation time of arteriovenous fistula. Methods Patients ( n = 80) with an end-stage renal disease requiring arteriovenous access surgery for hemodialysis with small caliber cephalic veins were randomized into two groups, i.e., hydrostatic dilatation and primary balloon angioplasty, each with 40 patients. All patients underwent a thorough clinical examination as well as duplex ultrasound vein mapping of both upper extremities. Patients were followed up for six months and primary patency, maturation time, and complications were noted. Results Immediate technical success with good palpable thrill was achieved in 97.5% of patients in the primary balloon angioplasty group and 87.5% in the hydrostatic dilatation group. The fistula maturation time in the primary balloon angioplasty group was 34.41 days and 46.18 days in the hydrostatic dilatation group. In the primary balloon angioplasty group, the primary patency of the fistula was 97.5% and 87.5% in the hydrostatic dilatation group, at six months. The arteriovenous fistula functioning rate was 77.5% in the hydrostatic dilatation group as compared to 92.5% in the primary balloon angioplasty group at six months. The incidence of surgical site infection was 5% in the primary balloon angioplasty group as compared to 10% in the hydrostatic dilatation group. Conclusion Primary balloon angioplasty of small caliber cephalic veins (≤2.5 mm) performed prior to arteriovenous fistula creation for hemodialysis is a beneficial procedure.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…11,14 Brachial artery was the common site to create AVF followed by radial artery, hence the same was dissected and anastomosed with the cephalic vein in this study to create AVF. 11,14…”

Section: Discussionmentioning

confidence: 99%

“…Although there were no re-interventions in this study, it has been demonstrated that the re-intervention rate is also low with PBA as compared to HD. 11…”

Section: Discussionmentioning

confidence: 99%

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