title: Cutting balloon angioplasty for undilatable venous stenoses causing dialysis graft failure.
abstract: Dialysis fistulas and bridge grafts frequently develop outflow stenoses in the venous limb, leading to graft failure. The venous stenoses are fibrotic and require percutaneous transluminal angioplasty with high-pressure balloons. We have encountered venous stenoses in 3 out of 219 hemodialysis patients with graft failure that were undilatable with 6-8 mm high-pressure balloons inflated to more than 24 atm. In each of these cases, treatment with a 4 mm cutting balloon successfully facilitated subsequent balloon dilation at lower pressures.
authors.affiliation: Ocala Heart Institute, Munroe Regional Medical Center, Ocala, Florida 34474, USA. jabittl@aol.com
authors.forename: John A
authors.initials: JA
authors.lastname: Bittl
authors.forename: Robert L
authors.initials: RL
authors.lastname: Feldman
mesh_terms: D000328:Adult; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*