Sometimes endovascular salvage of failing hemodialysis access is indispensable as you may not get another | ||
| The Egyptian Journal of Surgery | ||
| Volume 35, Issue 4, October 2016 PDF (223.78 K) | ||
| DOI: 10.4103/1110-1121.194738 | ||
| Authors | ||
| Hisham Ahmed; El-Sayed A. Abd El-Mabood; Refaat S. Salama | ||
| Abstract | ||
| Purposes This study aimed at salvaging fistulas using percutaneous transluminal balloon angioplasty (PTA) and evaluated the feasibility and safety of this PTA. Patients and methods A retrospective study was conducted on 15 patients to evaluate the results of endovascular intervention for the treatment of failing arteriovenous fistula from August 2015 until March 2016; these patients included eight (53.3%) men and seven (46.7%) women; most patients were aged between 40 and 60 years. Results Immediate success rate was 66.4% in anastomotic stenosis, 75% in juxta-anastomotic stenosis, and 100% in cases of central venous and arterial stenosis. Success rate after 6 months was mostly 50%, which necessitated re-PTA, except in central stenosis cases, which showed a success of 100%. Failed procedure was observed in three cases; two were due to puncture site hematoma and vein or anastomotic site rupture; these were treated with open surgery and ligation of the artery and vein proximal and distal to the anastomosis. Thrombosis was the cause of failure in the third case. Conclusion From this study we conclude that saving access can save life. Failing arteriovenous fistulas can be salvaged with PTA safely and effectively. Results are obtained with less trauma to the patient, preservation of access sites, and less postprocedural pain and wound edema. Centrally located stenoses are accessible. Re-PTA is needed in half of the patients. | ||
| Keywords | ||
| endovascular salvage; failing hemodialysis access; outcomes | ||
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