Dialysis access grafts: anatomic location of venous stenosis and results of angioplasty.
OBJECTIVE
To determine the distribution of stenoses and results of angioplasty in patients with similar forearm dialysis grafts made of polytetrafluoroethylene (PTFE).


METHODS
Diagnostic radiographs of the fistula obtained in 215 patients were reviewed; 90 patients had similar, unrevised forearm PTFE loop dialysis grafts. The location, morphology, and results of angioplasty were reviewed for each measurable stenosis. Surgical, radiologic, and dialysis records were reviewed to document the subsequent patency rate of each patient's dialysis access.


RESULTS
On the initial diagnostic fistulogram, 93 stenoses were identified. The anatomic distribution included 47% at the venous anastomosis and 11% within 1 cm of the anastomosis. Life table analysis revealed a 6-month patency rate of 63% and a 1-year patency rate of 41% for the first angioplasty in a given graft, and a 6-month patency rate of 44% and a 1-year patency rate of 22% [corrected] for the second angioplasty.


CONCLUSIONS
Performance of serial venous angioplasty procedures may help prolong the life of a graft, but the patency rates diminish with subsequent interventions.
Kanterman
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RY
Department of Radiology, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO 63110.
Vesely
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Pilgram
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Guy
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Windus
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Picus
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D000368:Aged; D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005542:Forearm / Q000098:blood supply; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D015993:Life Tables; D008297:Male; D010690:Phlebography / Q000379:methods; D011138:Polytetrafluoroethylene; D012008:Recurrence; D006435:Renal Dialysis; D012189:Retrospective Studies; D013382:Subtraction Technique; D014654:Vascular Patency
D011138:Polytetrafluoroethylene