Use of the Peripheral Cutting Balloon to Treat Hemodialysis-related Stenoses

Vesely, Thomas M.; Siegel, Jeffrey B.

doi:10.1097/01.rvi.0000190928.19701.dd

Cited by 130 publications

(87 citation statements)

References 14 publications

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“…Due to the cut surfaces, overdilation results in an increased risk of perforation. Therefore, the ratio of cutting balloon to reference vessel should not be greater than 1.1 to 1 [11]. However, compared to conventional PTA, cutting balloons require a greater introducer diameter and are comparatively expensive.…”

Section: Stenosis Of the Vascular Access Veinmentioning

confidence: 99%

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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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Section: Stenosis Of the Vascular Access Veinmentioning

confidence: 99%

“…A number of angiographic techniques are available for this purpose. Elastic or rigid stenoses can be treated by conventional PTA and stent implantation as well as by cutting balloon, for example [10,11]. To prevent recurrent stenoses, the use of drug-coated balloons is increasingly being reported [12,13].…”

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confidence: 99%

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Kamper

Faizy²,

Haage³

2015

Fortschr Röntgenstr

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“…The use of cutting balloons for treatment of high-pressure balloon-resistant stenotic lesions in AVGs and AVFs has been described in clinical reports and small studies (50)(51)(52)(53)(54). A multicenter randomized clinical trial of 340 patients with venous outflow stenoses reported equivalent 6-month patency rates between PTA alone and cutting balloon angioplasty, but the cutting balloon approach experienced a greater number of device-related complications, including venous rupture and dissections (55). Another randomized clinical trial is currently recruiting to assess the primary 1-year patency rate after treatment of vascular access stenotic lesions with cutting balloon angioplasty or PTA (Cutting Balloon Versus NonCutting Balloon for the Treatment of Venous Stenosis in the Fistulas of Hemodialyzed Patients; NCT01321866).…”

Section: Endovascular Approachesmentioning

confidence: 99%

Novel Therapies for Hemodialysis Vascular Access Dysfunction

Terry

Dember

2013

Clinical Journal of the American Society of Nephrology

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SummaryHemodialysis vascular access dysfunction is a major source of morbidity for patients with ESRD. Development of effective approaches to prevent and treat vascular access failure requires an understanding of the underlying mechanisms, suitable models for preclinical testing, systems for targeted delivery of interventions to maximize efficacy and minimize toxicity, and rigorous clinical trials that use appropriate outcome measures. This article reviews the substantial progress and ongoing challenges in developing novel treatments for arteriovenous vascular access failure and focuses on localized rather than systemic interventions.

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“…Both studies were randomized with comparable sample size, used the same technique for angioplasty and patency definitions, and conducted analysis on an intention-to-treat basis (1,2,10); however, one point regarding the protocols of the two studies helps to explain the patency discrepancy to some degree. In clinical trial by Vesely and Siegel (10), no routine follow-up diagnostic studies were performed. In other words, subsequent PTA was done only on the basis of clinical indications.…”

Section: Stent Graft For Stenosis At Vgamentioning

confidence: 99%

Stent Graft for Nephrologists

Salman

Asif

2010

Clinical Journal of the American Society of Nephrology

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The role of the stent graft is emerging in the management of arteriovenous dialysis access. Physicians are incorporating this device in the management of three distinct problems-vein-graft anastomotic stenosis, pseudoaneurysm formation, and cephalic arch stenosis-with varying degrees of success. Indeed, a recent randomized, controlled trial to evaluate the role of angioplasty plus stent graft versus angioplasty alone for the management of stenosis at the vein-graft anastomosis led to the approval of the stent graft by the Food and Drug Administration; however, several elements of the management of stenosis at the vein-graft anastomosis/cephalic arch as well as the repair of pseudoaneurysms by stent graft remain controversial. The situation is further complicated and warrants a cost-to-benefit ratio analysis when the added cost of the device is appended to the procedure. In contrast to the controversies, angioplasty-induced complete vascular rupture is one situation in which a stent graft is indicated beyond any doubt. With recent conditional Food and Drug Administration approval, it is anticipated that the use of stent grafts might increase in our patients. In this context, it is critically important that nephrologists be familiar with the current controversies and consensus that surround the use of stent grafts for dialysis access. Just as therapeutic interventions are analyzed in other disciplines within nephrology, these experts must appraise the use of this device for dialysis access. This report presents an up-to-date synopsis on the use of the stent graft that would assist renal physicians in requesting or rejecting the device for the optimal management of their patient's vascular access dysfunction.

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Use of the Peripheral Cutting Balloon to Treat Hemodialysis-related Stenoses

Cited by 130 publications

References 14 publications

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Diagnosis and Treatment of Insufficient Dialysis Vascular Access

Novel Therapies for Hemodialysis Vascular Access Dysfunction

Stent Graft for Nephrologists

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