Clinical factors affecting long-term patency after percutaneous transluminal angioplasty of insufficient hemodialytic arteriovenous fistula.
- Author:
Hyun Chaol LEE
1
;
Seung Hyea HYUN
;
Ji Young CHOI
;
Ja Yong PARK
;
Sung Won PARK
;
Ho Sang BAE
;
Young Jun CHO
;
Chan Duck KIM
;
Sun Hee PARK
;
Yong Lim KIM
Author Information
1. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. ylkim@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Angioplasty;
Hemodialysis;
Arteriovenous fistula
- MeSH:
Angiography;
Angioplasty*;
Arteriovenous Fistula*;
Diabetes Mellitus;
Fistula;
Hematoma;
Humans;
Renal Dialysis;
Risk Factors;
Spasm;
Thrombosis;
Transplants;
Veins
- From:Korean Journal of Medicine
2006;70(5):551-558
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study is to evaluate success rate and patency rate after percutaneous transluminal angioplasty (PTA) and to determine the factors affecting patency rate afterPTA in the management of insufficient arteriovenous fistula of hemodialysis patients. METHODS: Ninety-two cases of insufficient arteriovenous fistulae in 73 hemodialysis patients underwent angiography of the fistula and were treatedby PTA (native AVF: 67 cases, AV graft: 10 cases, central vein: 15 cases). The initial success rate and complications of PTA were evaluated. All patients were divided into two groups according to the age, sex, the duration of hemodialysis, a history of diabetes mellitus, the numbers of AVF operation, and the presence or absenceof thrombus. The patency rate was compared with the Kaplan-Meier method with log-rank test. To determine the clinical factors that affect vascular access failure rate, Cox regression method was used. RESULTS: The initial success rate of PTA was 78.2% (72/92). The patency rate after successful PTA was 80.0% at 6 months, and 73.2% at 12 months. The patency rate after successful PTA was significantly lower in cases which had two or more AVF operation (62.3% and 48.5% at 6 and 12 months) than just one (87.8% and 80.5% at 6 and 12 months). The most common PTA related complications were vessel spasm (3.9%) and hematoma (3.9%). CONCLUSIONS: The numbers of AVF operation was the only risk factor which affected the patency rate.
