Insufficient hemodialysis access fistulas: late results of treatment with percutaneous balloon angioplasty.
Forty-six patients with malfunctioning hemodialysis access fistulas were treated with balloon angioplasty. The initial percutaneous transluminal angioplasty procedure was successful in 16 (89%) of 18 patients with stenoses and in 13 (46%) of 28 with occlusions. In ten patients (seven with stenoses and three with occlusions) repeated dilation (two to five times; mean, two times) became necessary due to recurrent malfunction 1-24 months (mean, 6 months) after the first intervention. In the 16 patients with stenoses, the patency rate after 6 months was 93%; after 1 year, 91%; and after 2 years, 57%. In the 12 patients with occlusions, the rates were 80%, 50%, and 14%, respectively. Dilation of stenoses in malfunctioning hemodialysis fistulas is the procedure of choice. If hemodialysis shunts malfunction, immediate dilation of stenotic lesions should be performed to prevent occlusion.
Gmelin
E
E
Department of Radiology, Medical University of Lübeck, Federal Republic of Germany.
Winterhoff
R
R
Rinast
E
E
D000800:Angioplasty, Balloon; D001132:Arm / Q000098:blood supply; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D006801:Humans; D012008:Recurrence; D006435:Renal Dialysis; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*; D014654:Vascular Patency