The percutaneous treatment of angioaccess graft complications.
BACKGROUND
In the last decade, percutaneous techniques have been used with increasing frequency to treat angioaccess graft complications. The role of these procedures and their outcomes in patients on hemodialysis remains unclear.


METHODS
The records of all patients receiving percutaneous treatment of failed or failing angioaccess grafts were reviewed. Patient demographics, site and type of percutaneous intervention, and results of treatment were recorded. Survival curves were plotted using the Kaplan-Meier method, and differences in times to first failure between types of intervention were tested using the log rank method.


RESULTS
Grafts not requiring thrombolysis had significantly higher patency rates than those that did (P < 0.0001). Patency of grafts undergoing angioplasty of sites remote from the venous anastomosis were significantly higher than those of grafts undergoing venous anastomotic dilatation (P = 0.0004).


CONCLUSIONS
Percutaneous techniques are most effective in treating failing but patent angioaccess grafts, especially those with stenoses remote from the venous anastomosis. The efficacy of percutaneous techniques diminishes significantly when used to treat grafts that have progressed to occlusion.
Katz
S G
SG
Huntington Memorial Hospital, Pasadena, California, USA.
Kohl
R D
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000379:methods; D002408:Catheters, Indwelling; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D015912:Thrombolytic Therapy; D014654:Vascular Patency