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Surgical and Endovascular Intervention for Dialysis Access Maturation Failure During and After Arteriovenous Fistula Surgery: Review of the Evidence.
Tordoir, Jan H M; Zonnebeld, Niek; van Loon, Magda M; Gallieni, Maurizio; Hollenbeck, Markus.
Afiliação
  • Tordoir JHM; Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: j.tordoir@mumc.nl.
  • Zonnebeld N; Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • van Loon MM; Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Gallieni M; Nephrology and Dialysis Unit, Ospedale San Carlo Borromeo, University of Milano, Milan, Italy.
  • Hollenbeck M; Department of Nephrology and Rheumatology, Knappschaftskrankenhaus Bottrop, Bottrop, Germany.
Eur J Vasc Endovasc Surg ; 55(2): 240-248, 2018 Feb.
Article em En | MEDLINE | ID: mdl-29307757
ABSTRACT

BACKGROUND:

Maturation failure is the major obstacle to establishing functional arteriovenous fistulae (AVF) for haemodialysis treatment. Various endovascular and surgical techniques have been advocated to enhance fistula maturation and to increase the number of functional AVFs. This narrative review considers the available evidence of interventional techniques for treatment of AVF non-maturation.

RESULTS:

Intra-operative vein dilation and anastomosis modification results in a clinical maturation rate of 74-92% and a 6 month cumulative AVF patency of 79-93%. Percutaneous transluminal angioplasty (PTA) with or without accessory vein obliteration is successful in 43-97% of patients. The long-term primary patency of PTA is rather low and multiple re-interventions are needed to achieve an acceptable cumulative fistula patency. The results of surgical revision exceed the results of endovascular intervention, with a mean primary one year patency of 73% (range 68-78%) compared with 49% (range 28-72%), respectively. The role of accessory vein obliteration remains unclear.

CONCLUSION:

Intervention for autologous arteriovenous fistula non-maturation is worthwhile and results in an increased number of functional fistulae. The outcome of surgical revision is better than endovascular and might be preferable in certain patient populations.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reoperação / Derivação Arteriovenosa Cirúrgica / Diálise Renal / Angioplastia Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reoperação / Derivação Arteriovenosa Cirúrgica / Diálise Renal / Angioplastia Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2018 Tipo de documento: Article