ORIGINAL ARTICLE   

Italian Journal of Vascular and Endovascular Surgery 2019 June;26(2):81-4

DOI: 10.23736/S1824-4777.18.01376-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Outcome of angioplasty of occluded arteriovenous fistula for hemodialysis: single center experience

Baker GHONEIM ✉, Mahmoud NASSER, Hussein O. ELWAN

Department of Vascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt

BACKGROUND: The aim of this study was to evaluate the efficacy of endovascular salvage of dialysis when arteriovenous fistula (AVF) is completely occluded and assess the patency rates and predictors of failure after percutaneous transluminal angioplasty of the failed AVFs.
METHODS: This is a retrospective study conducted over a period of 24 months in our hospitals. The study includes all end-stage renal disease patients scheduled for/or already on regular hemodialysis presented with failed native AVF. History and clinical examination were done in all cases. Details of intervention were documented and assessment was done clinically and duplex before usage of AVFs for dialysis.
RESULTS: Fifty patients with occluded AVFs were included in the study. Mean age was 50-year-old. Sixty percent of cases was male and Hypertensive. 64% of AVFs was brachiocephalic AVF. Radial access was used as a single access in 78% of cases. Technical success is 84% and functional success (successful puncture and dialysis) was 78%. Primary and secondary patency rate at 12 months were 50% and 62% respectively. Early thrombosed AVF (<30 days duration) was a negative predictor for technical success.
CONCLUSIONS: Salvage of failed native AVFs could be done successfully with endovascular intervention without the use of thrombus removal strategies with an acceptable technical success and patency rate. The early thrombosed AVFs (<30 days) was a negative predictor for technical success.

KEY WORDS: Arteriovenous fistula; Angioplasty; Thrombectomy