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Percutaneous transluminal angioplasty against arteriosclerosis obliterans in dialysis patients

Kenji Tsuchida1, Yoshiaki Takemoto, Kazunobu Sugimura

  • 1Department of Urology and Division of Artificial Kidney, Osaka City University Medical School, Abeno-ku, Osaka City 545-8586, Japan. ktsuchida@msic.med.osaka-cu.ac.jp

International Journal of Molecular Medicine
|February 13, 2003
PubMed

Insights

Percutaneous transluminal angioplasty (PTA) for peripheral arteriosclerosis in dialysis patients has a high risk of complications. Careful patient selection and evaluation are crucial for successful PTA outcomes.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Peripheral arteriosclerosis is a growing concern in patients undergoing chronic hemodialysis.
  • Intervention (IV) treatment, including percutaneous transluminal angioplasty (PTA), is increasingly used for this complication.

Observation:

  • A study investigated 4 dialysis patients with arteriosclerosis obliterans (ASO) treated with IV.
  • Three of the four cases experienced unsuccessful outcomes, with complications including inability to pass the catheter, thrombus dispersion, and sudden death.

Findings:

  • The primary causes of PTA failure were severe vessel stenosis hindering catheter passage and forceful dilation leading to thrombus dispersion.
  • One case of successful IV was followed by acute myocardial infarction and sudden death, highlighting risks beyond the immediate procedure.

Implications:

  • While IV is an option for ASO in dialysis patients, its high risk of thrombus formation, vessel rupture, and organ failure necessitates careful patient assessment.
  • It is advisable to evaluate the patient's systemic condition thoroughly and consider IV primarily for cases with mild stenosis.

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