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Stent graft placement versus angioplasty for hemodialysis access failure: a meta-analysis

Huanrui Hu1, Zhoupeng Wu2, Jichun Zhao2

  • 1West China Medical School of Sichuan University, West China Hospital, Chengdu, Sichuan Province, China.

The Journal of Surgical Research
|April 18, 2018
PubMed

Insights

Stent graft placement significantly improves hemodialysis access patency compared to angioplasty alone. This intervention offers better long-term function for dialysis access circuits and treatment areas.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Hemodialysis is crucial for end-stage renal disease, with access patency being a critical factor.
  • Angioplasty is a common treatment for access stenosis but often results in restenosis.
  • Stent grafts offer a potential solution for maintaining high dialysis access patency.

Purpose of the Study:

  • To compare the primary patency of the treatment area and access circuit between stent grafts and angioplasty in patients with dialysis access failure.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials was conducted.
  • Searches were performed in PubMed, Cochrane Library, and EMBASE up to September 2017.
  • Four trials comparing stent grafts with angioplasty for hemodialysis access were included.

Main Results:

  • Stent graft placement demonstrated significantly higher primary patency in the treatment area (HR: 0.65, P < 0.0001).
  • Higher primary patency was also observed in the access circuit with stent grafts (HR: 0.76, P = 0.0004).
  • Pooled results showed no heterogeneity (I² = 0) across the included trials.

Conclusions:

  • Stent graft placement, potentially combined with angioplasty, leads to superior hemodialysis access patency compared to angioplasty alone.
  • This suggests stent grafts are an effective option for managing dialysis access failure.
Abstract

Keywords:
AngioplastyHemodialysis accessMeta-analysisStenosisStent grafts

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