Journal of vascular and interventional radiology : JVIR · 2013
Percutaneous interventions on the hemodialysis reliable outflow vascular access device.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Gebhard Thomas A, Bryant Joshua A, Adam Grezaffi J, Pabon-Ramos Waleska M, Gage Shawn M, Miller Michael J, Husum Kurt W, Suhocki Paul V, Sopko David R, Lawson Jeffrey H, Smith Tony P, Kim Charles Y
Аннотация
PURPOSE: To determine the outcomes of percutaneous interventions for prolonging the patency of the Hemodialysis Reliable Outflow (HeRO) device.
MATERIALS AND METHODS: Between January 2007 and August 2011, 73 percutaneous interventions were performed on 26 HeRO devices in 25 patients. The graft was implanted in the upper arm with the outflow catheter tip in the superior vena cava or right atrium. Procedural reports, angiographic images, and clinical notes were retrospectively reviewed. The primary and secondary patency rates after intervention were calculated using the Kaplan-Meier method.
RESULTS: The mean time from HeRO implantation to initial dysfunction or thrombosis was 171 days. In 60 (82%) procedures, the HeRO device was thrombosed. An intragraft stenosis was the most common lesion identified (59%; n = 43) followed by an arterial anastomosis stenosis identified in 18% (n = 13). In 22% (n = 16) of procedures in which the HeRO device was thrombosed, an underlying cause was not identified after thrombectomy. The 3-, 6-, and 12-month primary patency rates after intervention were 47%, 37%, and 26% for first-time interventions. The secondary patency rates were 80%, 70%, and 64%. The only complication was pulmonary embolism resulting in death 2 days after HeRO thrombectomy.
CONCLUSIONS: Percutaneous interventions on thrombosed and failing HeRO devices yielded acceptable primary and secondary patency rates after intervention in these patients with few, if any, alternatives for hemodialysis access.
MATERIALS AND METHODS: Between January 2007 and August 2011, 73 percutaneous interventions were performed on 26 HeRO devices in 25 patients. The graft was implanted in the upper arm with the outflow catheter tip in the superior vena cava or right atrium. Procedural reports, angiographic images, and clinical notes were retrospectively reviewed. The primary and secondary patency rates after intervention were calculated using the Kaplan-Meier method.
RESULTS: The mean time from HeRO implantation to initial dysfunction or thrombosis was 171 days. In 60 (82%) procedures, the HeRO device was thrombosed. An intragraft stenosis was the most common lesion identified (59%; n = 43) followed by an arterial anastomosis stenosis identified in 18% (n = 13). In 22% (n = 16) of procedures in which the HeRO device was thrombosed, an underlying cause was not identified after thrombectomy. The 3-, 6-, and 12-month primary patency rates after intervention were 47%, 37%, and 26% for first-time interventions. The secondary patency rates were 80%, 70%, and 64%. The only complication was pulmonary embolism resulting in death 2 days after HeRO thrombectomy.
CONCLUSIONS: Percutaneous interventions on thrombosed and failing HeRO devices yielded acceptable primary and secondary patency rates after intervention in these patients with few, if any, alternatives for hemodialysis access.
Предметные рубрики MeSH
Angiography, Digital SubtractionAngioplasty, BalloonArteriovenous Shunt, SurgicalBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationCentral Venous CathetersConstriction, PathologicEndovascular ProceduresEquipment DesignEquipment FailureFemaleFibrinolytic AgentsGraft Occlusion, VascularHumansKaplan-Meier EstimateMaleProsthesis DesignProsthesis FailureRenal DialysisRetrospective StudiesThrombectomyThrombolytic TherapyTime FactorsTissue Plasminogen ActivatorTreatment OutcomeUpper ExtremityUpper Extremity Deep Vein ThrombosisVascular Patency