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Related Experiment Videos

Percutaneous interventions for vascular dialysis access.

M Rocek1, J Peregrin

  • 1Department of Diagnostic Radiology, Inst Clin Exp Medicine, Prague, Czech Republic. miro@medicon.cz

EDTNA/ERCA Journal (English Ed.)
|March 1, 2002
PubMed
Summary

Early detection of failing vascular access, via stenosis or thrombosis, is key for long-term patency. Percutaneous treatments offer high success rates for both conditions, improving patient outcomes and reducing healthcare costs.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Nephrology

Background:

  • Long-term patency of vascular access is crucial for patients requiring dialysis.
  • Early detection of failing vascular access, specifically stenosis, is essential.
  • Vascular access occlusion due to thrombosis presents a more severe complication requiring effective treatment.

Purpose of the Study:

  • To review the efficacy and outcomes of percutaneous transluminal angioplasty for vascular access stenosis.
  • To evaluate the effectiveness of mechanical thrombectomy devices for treating occluded vascular access.
  • To compare the procedural characteristics and success rates of interventions for stenosis versus thrombosis.

Main Methods:

  • Fistulography followed by percutaneous transluminal angioplasty (PTA) for stenosis.
  • Mechanical dissolution, fragmentation, and aspiration devices for clot removal in occluded access.
  • Analysis of clinical success rates and procedural times for both stenosis and thrombosis interventions.

Main Results:

  • PTA for stenosis demonstrates high clinical success rates (85-98%) with procedure times of 30-60 minutes.
  • Mechanical thrombectomy for occluded access shows variable success rates (71-100%), with longer procedure times.
  • The incidence of serious complications associated with percutaneous treatments is low for both conditions.

Conclusions:

  • Percutaneous interventions are effective for managing failing vascular access due to stenosis and thrombosis.
  • Mechanical thrombectomy offers a less invasive outpatient option for occluded vascular access, reducing the need for central venous catheters.
  • Timely intervention for vascular access complications improves patient outcomes and potentially reduces healthcare costs.

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