Venous rupture during percutaneous treatment of hemodialysis fistulas and grafts

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
John A Bittl

Abstract

The aim of this study was to analyze the risk and consequences of venous rupture during angioplasty of malfunctioning hemodialysis grafts and fistulas. Venous stenoses in the outflow limb of hemodialysis accesses often require ultra-high balloon pressure for optimal dilatation. Baseline characteristics and outcomes were analyzed for a consecutive series of patients treated between 1999 and 2008. Venous rupture or perforation occurred in 11 of 1242 (0.9%) procedures. No patient with a rupture or perforation died or required emergency or urgent surgical repair. Two of 11 patients (18.2%) required transfusions, 8 of 11 patients (72.7%) required stenting, and 6 of 8 (75.0%) who needed stenting received covered stents to achieve hemostasis. Rupture led to access thrombosis within 30 days in 9 of 11 cases (82%). Multivariable logistical regression analysis suggested that using a balloon catheter more than 2 mm larger than the diameter of the hemodialysis access or using peripheral cutting balloons increased the risk of rupture or perforation. Rupture or perforation is a rare complication of treatment of malfunctioning hemodialysis grafts and fistulas. The complication may be managed with nonsurgical methods and might be avoided by op...Continue Reading

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Citations

Feb 23, 2011·Seminars in Dialysis·Gerald A BeathardAlex Weinstein
Oct 4, 2011·Journal of Vascular and Interventional Radiology : JVIR·Claude J RenaudLuc Turmel-Rodrigues
Mar 4, 2014·International Journal of Vascular Medicine·Ioannis BountourisMartin Malina
Feb 5, 2010·JACC. Cardiovascular Interventions·John A Bittl
Sep 10, 2015·The Journal of Vascular Access·Shigehiro Doi, Takao Masaki
Jun 18, 2011·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Ivo PetrovAngel Radev
May 23, 2018·International Journal of Vascular Medicine·Ioannis BountourisKonstantinos Ioannis Avgerinos
Feb 16, 2021·Progress in Cardiovascular Diseases·John A Bittl
Dec 1, 2021·The Journal of Vascular Access·Sudhakar M RaoJyothi Samath

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