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[Endovascular treatment of dysfunctional haemodialysis fistulas]

Marc Allan Hansen1, Kåre Gibsholm-Madsen, Tom Christensen

  • 1Kardiovaskulaert Afsnit X2021, Radiologisk Klinik, Diagnostisk Center, Rigshospitalet, DK-2100 København Ø. marc.hansen@rh.regionh.dk

Ugeskrift for Laeger
|January 9, 2009
PubMed

Insights

Percutaneous transluminal angioplasty (PTA) effectively treats stenosis in native arteriovenous fistulas (AVFs) for hemodialysis. This surveillance program demonstrated comparable success rates to existing literature.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Native arteriovenous fistula (AVF) is the preferred hemodialysis access.
  • Stenosis-induced thrombosis is a common AVF complication.
  • A surveillance program measuring access flow (Qa) was initiated in 2001.

Purpose of the Study:

  • To evaluate the implementation and outcomes of percutaneous transluminal angioplasty (PTA) for treating stenosis in native AVFs.
  • To assess the effectiveness of a surveillance program using access flow (Qa) measurements for timely intervention.

Main Methods:

  • A routine monitoring program measured access flow (Qa).
  • Patients with low flow rates underwent angiography.
  • Significant stenoses identified via angiography were treated with PTA.
  • 71 PTAs were performed in 52 patients between August 2001 and March 2004.

Main Results:

  • Technical success rate for PTA was 93% (66/71 procedures).
  • Clinically significant complications occurred in 4% (3/71) of cases.
  • The 2-year primary patency rate was 36%, and primary assisted patency was 67%.

Conclusions:

  • PTA is an effective treatment for stenosis in native hemodialysis fistulas.
  • The observed technical success, complication, and patency rates are consistent with published literature.
  • The integrated surveillance and intervention program supports AVF management.
Abstract

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