Impaired maturation of arteriovenous fistula for haemodialysis due to forearm artery stenosis: percutaneous endovascular treatment.
J Vasc Access
; 18(6): 503-507, 2017 Nov 17.
Article
in En
| MEDLINE
| ID: mdl-28777398
ABSTRACT
INTRODUCTION:
Distal autogenous arteriovenous fistula (dAVF), considered the "gold standard" vascular access for haemodialysis, suffers from a high rate of impaired maturation. One of the usual causes is low-flow associated forearm arterial stenosis. In such cases, endovascular treatment by percutaneous transluminal angioplasty represents a helpful option to enable maturation of the vascular access.Currently, there are few reports concerning the treatment of this complication. Therefore, we describe our single-centre experience based on a retrospective review of prospectively collected data. PATIENTS ANDMETHODS:
We treated 18 consecutive patients from July 2007 to January 2014 (16 radio-cephalic, 2 ulno-basilic distal AVF). A low flow due to forearm artery stenosis was diagnosed by duplex examination, as routinely performed one month after dAVF creation. An anterograde trans-brachial access was used for a 4-mm high-pressure angioplasty of the stenosed artery.RESULTS:
All interventions resulted in patent fistulas. Isolated percutaneous transluminal angioplasty (PTA) was required without need of stent placement. Mean blood flow increased from 304 mL/min, preoperatively, to 671 mL/min (p<0.01), as checked one week after the procedure. One-year primary and secondary patency were 84% ±7.3% and 92% ± 9.2%, respectively. Under no circumstances did access-induced distal ischemia occurred during follow-up.CONCLUSIONS:
Endovascular approach is a helpful and minimally invasive procedure for treatment of delayed maturation of dAVF related to forearm artery stenosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arterial Occlusive Diseases
/
Arteriovenous Shunt, Surgical
/
Renal Dialysis
/
Radial Artery
/
Angioplasty, Balloon
/
Renal Insufficiency, Chronic
/
Forearm
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
J Vasc Access
Year:
2017
Document type:
Article