Revista medica de Chile · 1996
[Percutaneous transluminal angioplasty (PTA) and intravascular stents in the treatment of central and peripheral venous stenoses of arteriovenous fistulae for chronic hemodialysis].
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Fava M, Loyola M S, Flores P
Аннотация
BACKGROUND: The maintenance of permeable vascular accesses in chronic hemodialysis patients is a major challenge.
AIM: To report our experience in the percutaneous treatment of venous stenoses of arteriovenous fistulae for hemodialysis.
PATIENTS AND METHODS: We studied retrospectively 48 patients with arteriovenous fistulae stenoses, that were followed during 24 months. When the fistulography disclosed an stenosis, a percutaneous transluminal angioplasty was performed. If indicated, an intravascular stent was installed or thrombolysis was done. These procedures were repeated as needed.
RESULTS: Twenty four patients had a peripheral vein stenosis, 20 had subclavian vein stenosis and 4 had both veins compromised. All were dilated with percutaneous transluminal angioplasty. Five stents were installed in the subclavian vein and five in peripheral veins. Two patients required thrombolysis. The procedure was successful in 96% of peripheral lesions and 92% of central lesions. There was regression of superior limb edema in 16 of 20 patients. Five patients had an hematoma in the puncture site. Twelve months later, 61% of treated peripheral and 42% of subclavian treated veins remained patent.
CONCLUSIONS: The use of percutaneous transluminal angioplasty and intravascular stents, maintains long term arteriovenous fistulae permeability and has similar results to surgical procedures.
AIM: To report our experience in the percutaneous treatment of venous stenoses of arteriovenous fistulae for hemodialysis.
PATIENTS AND METHODS: We studied retrospectively 48 patients with arteriovenous fistulae stenoses, that were followed during 24 months. When the fistulography disclosed an stenosis, a percutaneous transluminal angioplasty was performed. If indicated, an intravascular stent was installed or thrombolysis was done. These procedures were repeated as needed.
RESULTS: Twenty four patients had a peripheral vein stenosis, 20 had subclavian vein stenosis and 4 had both veins compromised. All were dilated with percutaneous transluminal angioplasty. Five stents were installed in the subclavian vein and five in peripheral veins. Two patients required thrombolysis. The procedure was successful in 96% of peripheral lesions and 92% of central lesions. There was regression of superior limb edema in 16 of 20 patients. Five patients had an hematoma in the puncture site. Twelve months later, 61% of treated peripheral and 42% of subclavian treated veins remained patent.
CONCLUSIONS: The use of percutaneous transluminal angioplasty and intravascular stents, maintains long term arteriovenous fistulae permeability and has similar results to surgical procedures.