ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2017 September;24(3):93-100

DOI: 10.23736/S1824-4777.17.01300-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Role of endovascular techniques in vascular access survival in hemodialysis patients

Ahmed R. TAWFIK ✉

Department of Vascular Surgery, Kasr Ani Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt

BACKGROUND: Patients with end-stage renal disease account for about 0.2% of the population. Maintenance of a functioning arteriovenous fistula (AVF) is critical for their life and poses a challenge for health care team who manages this group of patients. The aim of the present paper is to evaluate the role of endovascular techniques in the management of AVF complications; outcome and results.
METHODS: This is a prospective study on patients who attend the vascular out-patient clinic complaining of failing AVF or have AVF induced ischemia. Clinical assessment, angiography was performed in all patients. percutaneous transluminal angioplasty (PTA) with semi-compliant balloon angioplasty was performed for all patients. High-pressure balloon and/or stent used in lesions failed to be successfully managed.
RESULTS: In 74 patients, the location of lesions were in out-flow vein in 50 patients, central veins in 20 patients, and forearm arteries in 4 patients. PTA was performed in all patients while (14.89%) stented. Anatomical and clinical success rate was 95.5%. No major complication related to the procedures.
CONCLUSIONS: Endovascular intervention is a minimal invasive procedure extending the patency and maintain function of AVF in chronic renal failure patients on regular dialysis.

KEY WORDS: Failing AVF - Central venous occlusion - AVF induced hand ischemia