J Korean Radiol Soc.  1997 Oct;37(4):611-615.

Percutaneous Transluminal Angioplasty and Thrombolysis in the Management of Insufficient Hemodialysis Access: Long-Term Patency Rates and Factors Affecting Patency Rates

• Lee EH
• Yoon HK
• Kang SG
• Song HY
• Kwon TW
• Ji EK
• Kim KS
• Sung KB

Abstract

PURPOSE
To evaluate the success rates, long-term patency rates and factors affecting the patency rates of percutaneous transluminal angioplasty (PTA) and thrombolysis in the management of insufficient access during hemodialysis.
MATERIALS AND METHODS
Between January 1991 and March 1995, 37 insufficient shunts (23 native fistulae and 14 graft fistulae) were treated in 31 patients. PTA was performed in 24 shunts, and thrombolysis in13; in seven of these latter, thrombolysis was followed by PTA. The success and long-term patency rates of PTA and thrombolysis were evaluated. Shunts were subdivided according to a patient's age, type and age of the shunt, and number and length of the stenosis, and the degree of residual stenosis and in each subgroup, patency rates was compared.
RESULTS
The overall success rate of PTA and thrombolysis for insufficient hemodialytic access was 78.4% (29/37). The success rates of PTA and thrombolysis were 91.7% (22/24) and 53.8% (7/13), respectively. The patency rates of PTA (85.7% at 6 months, 78.6% at 12 months, and 55.9% at 24 months) were superior to those of thrombolysis (100% at 6 months and 0% at 12 months) (p=.014). Patency rates in each subgroup were not significantly different (p>.05).
CONCLUSION
The success and patency rates of PTA were superior to those of thrombolysis, and after PTA or thrombolysis, no factors affected patency rates.

Keyword

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

MeSH Terms

Angioplasty*
Arteriovenous Fistula
Constriction, Pathologic
Fistula
Humans
Renal Dialysis*
Transplants