J Korean Radiol Soc.  1998 Dec;39(6):1101-1106. 10.3348/jkrs.1998.39.6.1101.

Interventional Recanalization of Artificial Arteriovenous Fistula and Graft for Hemodialysis: Angioplasty andPulsed-Spray Thrombolysis with Urokinase

• Shin SW
• Do YS
• Park HS
• Choo SW
• Joh JW
• Kim YI
• Oh HY
• Shin MH
• Byun HS
• Choe YH
• Kim SH
• Choo IW
• Han BK

• KMID: 2201077
• DOI: http://doi.org/10.3348/jkrs.1998.39.6.1101

Abstract

PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pulsed-spraypharmacomechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodialysis access.
MATERIALS AND METHODS
Between September 1996 and May 1998, 21 insufficient hemodialysis accesses were treated in16 patients (3 artificial arteriovenous fistulae, AVF ; and 13 arteriovenous graft, AVG). PTA and PSPMT were performed in 6 and 15 and 15 cases, respectively, and success and long-term patency rates were evaluated.
RESULTS
The overall success rate of PTA and PSPMT for insufficient hemodialysis access was 76.2%(16/21). The success rates of PTA and PSPMT were 83.3%(5/6) and 73.3%(11/15), respectively. the primary patency rates of PSPMT were 69+/-12.8% at 6 months and 38+/-18.6% at 12 months. One of the two initially successful PTAs had been patent for 7months, and the second PTA was performed at that time due to venous stenosis. The other was patent for 15 months throughout the follow-up period.
CONCLUSION
PTA and PSPMT are effective primary methods for the treatment of insufficient hemodialysis access ; success and patency rates were high, and the procedures can be performed repeatedly.

Keyword

Veins, transluminal angioplasty; Dialysis, shunts; Fistula, arteriovenous; Thrombolysis

MeSH Terms

Angioplasty*
Arteriovenous Fistula*
Constriction, Pathologic
Follow-Up Studies
Humans
Renal Dialysis*
Transplants*
Urokinase-Type Plasminogen Activator*
Urokinase-Type Plasminogen Activator