Percutaneous Intervention in Axillary Loop-Configured Arteriovenous Grafts for Chronic Hemodialysis Patients.
10.3348/kjr.2010.11.2.195
- Author:
Beom Jin PARK
1
;
Hyoung Rae KIM
;
Hwan Hoon CHUNG
;
Deuk Jae SUNG
;
Sang Joon PARK
;
Ho Sung SON
;
Sang Kyung JO
;
Yun Hwan KIM
;
Sung Bum CHO
Author Information
1. Department of Radiology, College of Medicine, Korea University, Korea.
- Publication Type:Original Article
- Keywords:
Dialysis;
shunt Graft;
interventional procedure Veins;
transluminal angioplasty
- MeSH:
Adult;
Aged;
Angioplasty, Balloon/*methods;
Arteriovenous Shunt, Surgical/*methods;
Blood Vessel Prosthesis Implantation/*methods;
Chronic Disease;
Constriction, Pathologic/therapy/ultrasonography;
Female;
Follow-Up Studies;
Graft Occlusion, Vascular/*therapy/ultrasonography;
Humans;
Kidney Failure, Chronic/*complications/therapy;
Male;
Middle Aged;
*Renal Dialysis;
Subclavian Vein/ultrasonography;
Survival Analysis;
Treatment Outcome;
Vascular Patency
- From:Korean Journal of Radiology
2010;11(2):195-202
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study was to evaluate the fistulographic features of malfunctioning axillary loop-configured arteriovenous grafts and the efficacy of percutaneous interventions in failed axillary loop-configured arteriovenous grafts. MATERIALS AND METHODS: Ten patients with axillary loop-configured arteriovenous grafts were referred for evaluation of graft patency or upper arm swelling. Fistulography and percutaneous intervention, including thrombolysis, percutaneous transluminal angioplasty and stent placement, were performed. Statistical analysis of the procedure success rate and the primary and secondary patency rates was done. RESULTS: Four patients had graft related and subclavian venous stenosis, two patients had graft related stenosis and another four patients had subclavian venous stenosis only. Sixteen sessions of interventional procedures were performed in eight patients (average: 2 sessions / patient) until the end of follow-up. An interventional procedure was not done in two patients with central venous stenosis. The overall procedure success rate was 69% (11 of 16 sessions). The post-intervention primary and secondary patency rates were 50% and 63% at three months, 38% and 63% at six months and 25% and 63% at one year, respectively. CONCLUSION: Dysfunctional axillary loop-configured arteriovenous grafts almost always had subclavian venous and graft-related stenosis. Interventional treatments are helpful to overcome this and these treatments are expected to play a major role in restoring and maintaining the axillary loop-configured arteriovenous loop grafts.
