Outpatient treatment of arterial inflow stenoses of dysfunctional hemodialysis access fistulas by retrograde venous access puncture and catheterization

Journal of Vascular Surgery
Lucien E M DuijmJaap Buth

Abstract

To determine the feasibility of endovascular treatment of inflow stenoses in arteriovenous fistulae (AVFs) through retrograde venous access catheterization. We included all 22 dysfunctional AVFs with arterial inflow stenoses at access imaging between January 2002 and September 2006. Following retrograde venous access puncture, an interventional radiologist intended to cross the arteriovenous anastomosis and advance a catheter into the aortic arch. After depiction of the complete vascular access tree, angioplasty and/or stent placement was aimed for stenoses with a >50% luminal diameter reduction at digital subtraction angiography (DSA). In one radiocephalic AVF, a catheter could not be positioned into the aortic arch after retrograde venous access puncture. DSA depicted 28 inflow stenoses in the remaining 21 patients (11 radiocephalic AVFs and 10 brachiocephalic AVFs). Clinical improvement was obtained in 18 out of 19 patients with a technically successful intervention (<30% residual stenosis after angioplasty or stent placement). Following endovascular therapy, access flow of 12 patients with a low flow access improved from 431 +/- 150 ml/min to 818 +/- 233 ml/min, and four patients with steal symptoms became symptom free. One...Continue Reading

References

Mar 7, 2001·Radiology·S O Trerotola, L A Turmel-Rodrigues
Nov 13, 2002·Journal of Vascular and Interventional Radiology : JVIR·Faraz A Khan, Thomas M Vesely
Feb 26, 2004·Journal of Vascular Surgery·L Richard SprouseJohn O Colonna
Jun 27, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Arif AsifFlorin N Gadalean
Jun 27, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Lucien E M DuijmAlexander V Tielbeek
Jul 4, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·UNKNOWN Vascular Access Work Group

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Citations

Nov 18, 2011·Journal of Vascular and Interventional Radiology : JVIR·Kenneth D MandatoChristopher Doti
Jun 6, 2013·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Chi-Cheng LaiChun-Peng Liu
Sep 14, 2016·Journal of Vascular and Interventional Radiology : JVIR·Sean R DariushniaUNKNOWN Society of Interventional Radiology Standards of Practice Committee
Aug 22, 2009·Advances in Chronic Kidney Disease·Gerald A Beathard
Jan 22, 2013·The Journal of Vascular Access·Fernando CaeiroFernando Nolasco
May 13, 2014·The Journal of Vascular Access·Lars KamperPatrick Haage

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