[Angioplasty in the stenosed hemodialysis shunt: experiences with 100 patients and 166 interventions].
OBJECTIVE
Failing dialysis fistulas are a severe complication for patients treated by chronic haemodialysis. This study was undertaken to evaluate the technical aspects of percutaneous transluminal angioplasty (PTA) of shunts and to report on our experience in 100 patients.


METHODS
In a 4-year period a total of 166 PTA procedures was performed in 100 haemodialysis patients with stenosis and occlusion of Brescia Cimino shunts and PTFE grafts (polytetrafluoroethylene). Patency rates were retrospectively evaluated for type and location of lesions, patient age, sex and the success of PTA.


RESULTS
Technical success was achieved in 97% (n = 161). Complications appeared in 11 cases (6.6%). Shunt occlusion or rupture of a vein is rare. The cumulative patency rate for primary PTA treatment was 55% at 6 months, 47% at 12 months and 32% at 24 months and for repeat PTA treatment 87% at 6 months, 80% at 12 months and 70% at 24 months. Residual stenosis and diabetes mellitus significantly reduced the patency rate.


CONCLUSIONS
PTA is an ideal method for accomplishing recurrent fistula failure due to its cost effectiveness and minimally invasive procedure. Recurrent stenosis has been a major problem of PTA as also in equal measure with surgical intervention.
Institut für Radiologie, Augusta-Kranken-Anstalt Bochum.
D
D
Longwitz
T H
TH
Pham
R G
RG
Heckemann
E
E
Hecking
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000706:statistics & numerical data; D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011379:Prognosis; D015641:Radiography, Interventional; D006435:Renal Dialysis; D012189:Retrospective Studies
D011138:Polytetrafluoroethylene