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Is Repeat PTA of a Failing Hemodialysis Fistula Durable?

Bountouris, Ioannis; Kristmundsson, Thorarinn LU ; Dias, Nuno LU ; Zdanowski, Zbigniew and Malina, Martin LU (2014) In International Journal of Vascular Medicine 2014(Jan 22).
Abstract
Purpose. Our objective was to evaluate the outcome of percutaneous transluminal angioplasty (PTA) and particularly rePTA in a failing arteriovenous fistula (AV-fistula). Are multiple redilations worthwhile? Patients and Methods. All 159 stenoses of AV fistulas that were treated with PTA, with or without stenting, during 2008 and 2009, were included. Occluded fistulas that were dilated after successful thrombolysis were also included. Median age was 68 (interquartile range 61.5-78.5) years and 75% were male. Results. Seventy-nine (50%) of the primary PTAs required no further reintervention. The primary patency was 61% at 6 months and 42% at 12 months. Eighty (50%) of the stenoses needed at least one reintervention. Primary assisted patency... (More)
Purpose. Our objective was to evaluate the outcome of percutaneous transluminal angioplasty (PTA) and particularly rePTA in a failing arteriovenous fistula (AV-fistula). Are multiple redilations worthwhile? Patients and Methods. All 159 stenoses of AV fistulas that were treated with PTA, with or without stenting, during 2008 and 2009, were included. Occluded fistulas that were dilated after successful thrombolysis were also included. Median age was 68 (interquartile range 61.5-78.5) years and 75% were male. Results. Seventy-nine (50%) of the primary PTAs required no further reintervention. The primary patency was 61% at 6 months and 42% at 12 months. Eighty (50%) of the stenoses needed at least one reintervention. Primary assisted patency (defined as patency after subsequent reinterventions) was 89% at 6 months and 85% at 12 months. The durability of repeated PTAs was similar to the durability of the primary PTA. However, an early primary PTA carried a higher risk for subsequent reinterventions. Successful dialysis was achieved after 98% of treatments. Nine percent of the stenoses eventually required surgical revision and 13% of the fistulas failed permanently. Conclusion. The present study suggests that most failing AV-fistulas can be salvaged endovascularly. Repeated PTA seems similarly durable as the primary PTA. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Vascular Medicine
volume
2014
issue
Jan 22
publisher
Hindawi Publishing Corporation
external identifiers
  • pmid:24587906
  • scopus:84893842245
ISSN
2090-2824
DOI
10.1155/2014/369687
language
English
LU publication?
yes
id
7a965fce-1a72-481b-8094-ac797dbf7a1b (old id 4384069)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24587906?dopt=Abstract
date added to LUP
2014-04-01 19:24:20
date last changed
2017-07-09 03:15:34
@article{7a965fce-1a72-481b-8094-ac797dbf7a1b,
  abstract     = {Purpose. Our objective was to evaluate the outcome of percutaneous transluminal angioplasty (PTA) and particularly rePTA in a failing arteriovenous fistula (AV-fistula). Are multiple redilations worthwhile? Patients and Methods. All 159 stenoses of AV fistulas that were treated with PTA, with or without stenting, during 2008 and 2009, were included. Occluded fistulas that were dilated after successful thrombolysis were also included. Median age was 68 (interquartile range 61.5-78.5) years and 75% were male. Results. Seventy-nine (50%) of the primary PTAs required no further reintervention. The primary patency was 61% at 6 months and 42% at 12 months. Eighty (50%) of the stenoses needed at least one reintervention. Primary assisted patency (defined as patency after subsequent reinterventions) was 89% at 6 months and 85% at 12 months. The durability of repeated PTAs was similar to the durability of the primary PTA. However, an early primary PTA carried a higher risk for subsequent reinterventions. Successful dialysis was achieved after 98% of treatments. Nine percent of the stenoses eventually required surgical revision and 13% of the fistulas failed permanently. Conclusion. The present study suggests that most failing AV-fistulas can be salvaged endovascularly. Repeated PTA seems similarly durable as the primary PTA.},
  articleno    = {369687},
  author       = {Bountouris, Ioannis and Kristmundsson, Thorarinn and Dias, Nuno and Zdanowski, Zbigniew and Malina, Martin},
  issn         = {2090-2824},
  language     = {eng},
  number       = {Jan 22},
  publisher    = {Hindawi Publishing Corporation},
  series       = {International Journal of Vascular Medicine},
  title        = {Is Repeat PTA of a Failing Hemodialysis Fistula Durable?},
  url          = {http://dx.doi.org/10.1155/2014/369687},
  volume       = {2014},
  year         = {2014},
}