J Korean Radiol Soc.  1999 Jun;40(6):1105-1111. 10.3348/jkrs.1999.40.6.1105.

Effect of Percutaneous Transluminal Angioplasty in insufficiency of Arteriovenous Fistula for Hemodialysis

• Choi CS
• Goo DE
• Kim KS
• Kim HH
• Kim DH
• Choi DL
• Mun C
• Lee HB

• KMID: 2200933
• DOI: http://doi.org/10.3348/jkrs.1999.40.6.1105

Abstract

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine thefactors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenousfistula(AVF).
MATERIALS AND METHODS
Forty-nine cases of insufficient hemodialytic AVF were treated in 44patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis wasperformed with urokinase, and was followed by PTA. The initial success rate and complications of PTA wereevaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient 's age, and the duration of renal failure, patency rateswere compared within each subgroup using the Kaplan-Meier logrank test.
RESULTS
The initial success rate of PTAfor insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12months. The initial success rate of thrombolysis was 89%(25/28). The complication rate of PTA was 12%(6/49), ofwhich five cases were vein rupture, and one was subcutaneous hematoma. Statistically, the patency rates in theabove mentioned subgroups were not significantly different.
CONCLUSION
PTA with or without thrombolysis offerssafe and effective management of insufficient hemodialytic AVF.

Keyword

Dialysis, shunts; Fistula, arteriovenous; Arteries, transluminal angioplasty

MeSH Terms

Angioplasty*
Arteriovenous Fistula*
Constriction, Pathologic
Hematoma
Humans
Renal Dialysis*
Renal Insufficiency
Rupture
Thrombosis
Transplants
Urokinase-Type Plasminogen Activator
Veins
Urokinase-Type Plasminogen Activator