Interwoven Nitinol Stents to Treat Radiocephalic Anastomotic Arteriovenous Fistula Stenosis.
J Endovasc Ther
; 26(3): 394-401, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-30973045
PURPOSE: To determine the clinical outcomes in hemodialysis patients after implantation of a Supera stent to treat juxta-anastomotic stenosis in radiocephalic arteriovenous fistulas (AVF). MATERIALS AND METHODS: A single-center retrospective study was conducted of 42 consecutive patients (mean age 66.7 years, range 40-84; 26 men) who had a failing AVF due to juxta-anastomotic stenosis treated with the interwoven Supera stent between February 2014 and February 2018. A third of the patients had previous juxta-anastomotic intervention (either balloon angioplasty or open surgical revision). RESULTS: The stent was inserted successfully in all patients. Overall mean follow-up was 12.2±8.2 months (range 3.8-38.3). Juxta-anastomotic segment primary patency estimates at 6 and 12 months were 92.5% and 59.8%, respectively, with assisted primary patency rates of 97.5% and 92.9%. Reintervention (elective drug-coated balloon angioplasty) occurred at a rate of 0.31 procedures/year. Two AVFs thrombosed during the 1-year follow-up and were revascularized using balloon angioplasty. Ultrasound measurements of brachial artery flow rates increased significantly from 543.5±96.72 mL/min (range 430-644) before intervention to 919.2±355.9 mL/min (range 200-1600) after intervention (p=0.047). Arterial pressures on hemodialysis improved from -142.3±24.9 mm Hg (range -100 to -180) to -123.4±21.9 mm Hg (range -100 to -184; p=0.051). No AVFs were lost or abandoned during the follow-up period. CONCLUSION: The interwoven Supera stent is a promising treatment for failing AVFs with juxta-anastomotic stenosis. Encouraging 1-year primary and assisted primary patency was demonstrated, with a low reintervention rate. This treatment facilitates long-term maintenance of AVF vascular accesses.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Veias
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Derivação Arteriovenosa Cirúrgica
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Stents
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Diálise Renal
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Artéria Radial
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Extremidade Superior
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Ligas
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Procedimentos Endovasculares
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Oclusão de Enxerto Vascular
Tipo de estudo:
Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Endovasc Ther
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália