Transluminal angioplasty of venous stenoses in polytetrafluoroethylene vascular access grafts

Schwab, Steve J.; Saeed, Mohsin; Sussman, Steven K.; McCann, Richard L.; Stickel, Delford L.

doi:10.1038/ki.1987.223

Cited by 55 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Percutaneous transluminal angioplasty has become a standard treatment for the correction of stenosis in AVF and AV graft 46–48 . The technique has been demonstrated to be safe, easily performed, and effective.…”

Section: Discussionmentioning

confidence: 99%

Stenosis in hemodialysis arteriovenous fistula: Evaluation and treatment

Campos

Nascimento

Chula

et al. 2006

Hemodialysis International

View full text Add to dashboard Cite

Vascular access complications are one of the main causes associated with an increase in morbidity and mortality in stage 5 chronic kidney disease patients. The arteriovenous fistula is regarded as the vascular access of choice for hemodialysis (HD) because of its superior patency and lower complication rates. Stenosis is considered the major cause of dysfunction of arteriovenous fistula. Despite the relatively low thrombosis rates of arteriovenous fistula, surveillance programs are necessary for detection of stenosis. We report a case of a HD patient who had never achieved an adequate Kt/V since the start of maintenance HD. During the investigation, abnormal findings were found on physical examination of the fistula, in addition to an alteration in intra-access pressure (IAP) measurements. A venous stenosis was diagnosed by Doppler ultrasound and then promptly treated with percutaneous transluminal angioplasty. The purpose of the discussion is to highlight the peculiarities of arteriovenous fistulae, methods of surveillance, including physical examination, IAP, recirculation, and measurements of blood flow, and the importance of the correction procedures for the stenosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Stenosis in hemodialysis arteriovenous fistula: Evaluation and treatment

Campos

Nascimento

Chula

et al. 2006

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…But the maintenance of patency using a PTFE graft is difficult, and the reported patency rates at 1 year have varied from 55 to 75% [9][10][11][12][13], The loss of patency is due to the occurrence of stenosis, and it has been reported that stenosis at the graft-vein anasto motic site is the most frequent. However, stenosis may occur anywhere within the native vein proximal to the graft or within the graft itself [12,14,15]. The graftvenous anastomotic site was the second most frequent site in our study also.…”

Section: Discussionmentioning

confidence: 57%

The Treatment of Chronic Hemodialysis Vascular Access by Directional Atherectomy

Mizumoto

Watanabe

Kumon

et al. 1996

Nephron

View full text Add to dashboard Cite

Directional atherectomy (DA) was developed as a new therapeutic modality for coronary artery disease. For the past 3 years, we have applied DA intervention to vascular access failure with either poor blood flow rate or high venous pressure. DA intervention was performed on 27 lesions of 16 hemodialyzed patients. A reduction of stenosis to less than 20% of that before treatment was judged a technical success, and the rate of technical success was 84%. All patients showed adequate blood flow rates after DA intervention, indicating initial success. Although restenotic events occurred frequently, repeated DA interventions could be performed successfully. The patency rate at 1 month after DA intervention was 100%, at 3 months 93%, at 6 months 92% and at 12 months 75%. The short-term patency rate of DA was more satisfactory than the results of percutaneous transluminal angioplasty as reported by several investigators. Regarding the site of stenosis, restenotic events were relatively fewer in the lesions occurring at the native vein compared to those at graft-venous anastomotic sites. Eccentric-type stenosis was also associated with fewer restenotic events than circumferential-type stenosis. These results suggest that eccentric-type stenosis at the native vein is the most suitable lesion for the application of DA intervention in terms of long-term patency. As no severe complications occurred after DA intervention, this would appear to be a useful therapeutic modality for the correction of vascular access failure.

show abstract

“…24 Since 1984, percutaneous transluminal angioplasty (PTA) with high-pressure balloon catheters was the initial approach to restore the patency of polytetrafluoroethylene (PTFE) hemodialysis vascular access grafts. In 1987, Schwab et al 25 reported that the PTA technique was a non-surgical option for salvage of failing PTFE grafts. PTA was shown to prolong the life of PTFE vascular access grafts and could be easily performed on an outpatient basis, eliminating the need for hospitalization that was usually required for surgical revision.…”

Section: The Doldrumsmentioning

confidence: 98%