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INTERNATIONAL ANGIOLOGY

A Journal on Angiology


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2018 Jan 26

DOI: 10.23736/S0392-9590.18.03933-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Surgical revision vs. stent-graft to treat venous anastomosis stenosis following surgical thrombectomy of hemodialysis grafts

Jana JANECKOVA 1 , Petr BACHLEDA 1, Petr UTIKAL 1, Martin KÖCHER 2, Marie CERNA 2, Pavel XINOPULOS 1

1 Department of Surgery II, Vascular and Transplantation Surgery, University Hospital Olomouc, Olomouc, Czech Republic; 2 Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic


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BACKGROUND: There is no unanimous strategy for treating stenosis of the venous anastomosis (VA) of an occluded arteriovenous graft (AVG) following surgical thrombectomy. In this study, we compared classical surgical treatment and endovascular treatment procedures with the use of stent- graft in a single center study. The aim was to evaluate whether, the VA stenosis of thrombosed AVG treated endovascularly by stent-graft implantation, have as good results as surgical VA treatment, so that it may be considered the method of choice.
METHODS: The study included patients who underwent surgical AVG thrombectomy with subsequent angiographically confirmed VA stenosis between 1/2009 and 12/2014. Surgical angioplasty was then performed in 15 patients and 17 patients underwent primary stent-graft implantation.
RESULTS: In the surgically treated patients, the postintervention primary potency, primary assisted patency and secondary patency after 12 months were 50.7%, 56.3%, 62.4%, respectively. In the group of patients with occluded AVG who underwent stent-graft implantation, the postintervention primary patency, primary assisted patency and secondary patency after 12 months were 32.8%, 44.1% a 55.6%, respectively. No statistically significant difference in primary patency (p =0.391), primary assisted patency (p = 0.605), and secondary patency (p = 0.702) was observed between the groups.
CONCLUSIONS: Stent-graft implantation into stenotic VA of an occluded AVG showed to be effective and maintained good long-term patency. It is the preferred method due to its minimal invasiveness. The superiority of this method must be confirmed on a larger set of patients.


KEY WORDS: Arteriovenous graft - Venous anastomosis - Stent-graft implantation - Surgical angioplasty

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Publication History

Article first published online: January 26, 2018
Manuscript accepted: January 23, 2018
Manuscript received: October 9, 2017

Cite this article as

Janeckova J, Bachleda P, Utikal P, Köcher M, Cerna M, Xinopulos P. Surgical revision vs. stent-graft to treat venous anastomosis stenosis following surgical thrombectomy of hemodialysis grafts. Int Angiol 2018 Jan 26. DOI: 10.23736/S0392-9590.18.03933-0

Corresponding author e-mail

jana.fialova@email.cz