Percutaneous venous angioplasty in the treatment of stenotic lesions affecting dialysis fistulas.
A systematic approach was used to detect venous stenotic fistula lesions in a large dialysis population. All significant stenoses were treated with percutaneous venous angioplasty (PTVA). A total of 380 PTVAs were done in 241 patients. It was possible to dilate 96% of lesions successfully. A complication rate of 3.4% was seen, and only two fistulas were lost. Patient follow-up consisted of monitoring percent decrease in venous resistance (VR) and determining long-term patency. The VR was decreased 35.4% at 1 week and 23.5% at 3 months; 58% of the treated fistulas continued to be patent at 6 months, and 35% at 12 months. It was concluded that PTVA can prolong the life of hemodialysis fistulas successfully with a low level of complications. The lesions tend to recur, but they can be retreated successfully, obviating surgery and preventing the depletion of potential vascular access sites.
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GA
D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D012008:Recurrence; D006435:Renal Dialysis; D014655:Vascular Resistance / Q000502:physiology