Related Experiment Video

Updated: Oct 23, 2026

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
06:27

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

Published on: July 20, 2022

Percutaneous transluminal coronary angioplasty for chronic dialysis patients

S Takeshita1, T Isshiki, H Tagawa

  • 1Department of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.

The Journal of Invasive Cardiology
|October 5, 1993
PubMed

Insights

Percutaneous transluminal coronary angioplasty (PTCA) is a viable initial treatment for hemodialysis patients with angina. However, restenosis rates are high, especially with longer dialysis history, suggesting surgery may be better in such cases.

Area of Science:

  • Cardiology
  • Nephrology
  • Vascular Medicine

Background:

  • Accelerated atherosclerosis causes significant mortality in hemodialysis patients, with coronary artery disease being a major contributor.
  • The efficacy of percutaneous transluminal coronary angioplasty (PTCA) in this patient population is not well-established.
  • Medically refractory angina pectoris is common in patients undergoing chronic hemodialysis.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of PTCA in patients on chronic hemodialysis.
  • To determine the success rates and restenosis rates of PTCA in this specific cohort.
  • To identify factors associated with restenosis after PTCA in hemodialysis patients.

Main Methods:

  • PTCA was performed on 15 hemodialysis patients experiencing medically refractory angina.
  • Angiographic success was defined as successful stenosis treatment after PTCA.
  • Restenosis rates and recurrence of angina were monitored post-procedure.

Main Results:

  • Angiographic success was achieved in 76% of attempted stenoses after the initial PTCA.
  • Restenosis occurred in 38% of treated lesions, significantly linked to longer dialysis history and lower inflation pressure.
  • Repeat PTCA procedures showed high rates of angina recurrence and further restenosis, particularly in patients with longer dialysis histories.

Conclusions:

  • PTCA serves as a reasonable initial therapeutic strategy for hemodialysis patients with angina, especially those with a shorter dialysis history.
  • High restenosis rates in patients with longer dialysis histories or after repeat procedures suggest that coronary bypass surgery should be considered.
  • Further research is warranted to optimize PTCA outcomes and patient selection in this high-risk group.

Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...