[Percutaneous transluminal angioplasty (PTA) and intravascular stents in the treatment of central and peripheral venous stenoses of arteriovenous fistulae for chronic hemodialysis].
BACKGROUND
The maintenance of permeable vascular accesses in chronic hemodialysis patients is a major challenge.


OBJECTIVE
To report our experience in the percutaneous treatment of venous stenoses of arteriovenous fistulae for hemodialysis.


METHODS
We studied retrospectively 48 patients with arteriovenous fistulae stenoses, that were followed during 24 months. When the fistulography disclosed an stenosis, a percutaneous transluminal angioplasty was performed. If indicated, an intravascular stent was installed or thrombolysis was done. These procedures were repeated as needed.


RESULTS
Twenty four patients had a peripheral vein stenosis, 20 had subclavian vein stenosis and 4 had both veins compromised. All were dilated with percutaneous transluminal angioplasty. Five stents were installed in the subclavian vein and five in peripheral veins. Two patients required thrombolysis. The procedure was successful in 96% of peripheral lesions and 92% of central lesions. There was regression of superior limb edema in 16 of 20 patients. Five patients had an hematoma in the puncture site. Twelve months later, 61% of treated peripheral and 42% of subclavian treated veins remained patent.


CONCLUSIONS
The use of percutaneous transluminal angioplasty and intravascular stents, maintains long term arteriovenous fistulae permeability and has similar results to surgical procedures.
Fava
M
M
Departamento de Radiología, Hospital Clínico, P Universidad Católica, Santiago de Chile.
Loyola
M S
MS
Flores
P
P
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D006435:Renal Dialysis; D012189:Retrospective Studies; D015607:Stents; D014654:Vascular Patency