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Safety and efficacy of a new covered stent in hemodialysis vascular access outflow stenosis: A Brazilian multicenter retrospective study.
Harduin, Leonardo de Oliveira; Barroso, Thiago Almeida; Guerra, Julia Bandeira; Filippo, Márcio Gomes; de Almeida, Leonardo Cortizo; Vieira, Brunno Ribeiro; Mello, Renata Silveira; Galhardo, Adriano Martins; Castro-Santos, Guilherme de; Virgini-Magalhães, Carlos Eduardo; Strogoff-de-Matos, Jorge Paulo.
Afiliação
  • Harduin LO; Liv Care Centro Clínico, Niterói, Rio de Janeiro, Brazil.
  • Barroso TA; Afya Hospital Dia, Brasília, Distrito Federal, Brazil.
  • Guerra JB; Image Department, Hospital Niterói Dor and Centro Clínico LIVCARE, Niterói (Rio de Janeiro), Brazil.
  • Filippo MG; Vascular Surgery Service, Hospital Universitário Clementino Fraga Filho (HUCFF), Universidade Federal do Estado do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil.
  • de Almeida LC; Vascular Surgery Service, Hospital Ana Nery, Salvador, Bahia, Brazil.
  • Vieira BR; Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, Rio de Janeiro, Brazil.
  • Mello RS; Vascular Surgery Service, Hospital Niterói Dor, Niterói, Rio de Janeiro, Brazil.
  • Galhardo AM; Afya Centro de Acesso Vascular, Brasília, Distrito Federal, Brazil.
  • Castro-Santos G; Surgery Department, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil.
  • Virgini-Magalhães CE; Vascular and Endovascular Surgery Department, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
  • Strogoff-de-Matos JP; Division of Nephrology, Department of Medicine, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
J Vasc Access ; : 11297298231226259, 2024 Feb 05.
Article em En | MEDLINE | ID: mdl-38316624
ABSTRACT

BACKGROUND:

Vascular stenosis commonly leads to dysfunction in hemodialysis vascular access. Although percutaneous transluminal angioplasty is an established treatment, stent utilization has increased in the last decade as an alternative solution to extend the access function. This study evaluated the safety and initial results of a new impermeable covered stent for treating vascular access outflow stenosis.

METHODS:

Investigators retrospectively analyzed 114 hemodialysis patients treated with polytetrafluorethylene-covered stents from September 2018 to September 2022 across four centers. Lesions treated were de novo or restenotic and located in the venous graft anastomosis, outflow segment, cephalic arch, and basilic swing point. Patients were followed by in-person physical examination at 1, 3, and 6 months, and Duplex ultrasound was performed to evaluate the vascular access circuit and in-stent restenosis. The primary efficacy endpoint was target lesion primary patency at 1, 3, and 6 months. Secondary endpoints included access circuit primary patency and secondary patency at 1, 3, and 6 months. The primary safety endpoint was freedom from local or systemic serious adverse events through 30 days post-procedure.

RESULTS:

Forty-four patients had thrombosed access at the initial presentation, and 41 patients presented with recurrent stenosis. The target lesion primary patency rates at 1, 3, and 6 months were 100%, 89.4%, and 74%, respectively. The access circuit primary patency rates were 100% at 1 month, 85% at 3 months, and 62.7% at 6 months. The secondary patency rates at 1, 3, and 6 months were 100%, 96.4%, and 94.6%, respectively. In the adjusted multivariate Cox regression analysis, only recurrent lesions and female gender were associated with reduced primary patency rates. No serious adverse event was observed through the first 30 days post-procedure.

CONCLUSION:

In this retrospective analysis, a new covered stent was shown to be safe and effective for treating peripheral outflow stenosis in vascular access.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Risk_factors_studies País como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Clinical_trials / Observational_studies / Risk_factors_studies País como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2024 Tipo de documento: Article