Percutaneous transluminal angioplasty in the treatment of stenosis of arteriovenous fistulae for hemodialysis.
BACKGROUND
Thrombosis following stenosis of arteriovenous fistulae resulting in the loss of vascular access for hemodialysis is an important complication in patients with chronic renal failure. Percutaneous transluminal angioplasty is being used more frequently in the treatment of stenosis aiming at increasing the patency of arteriovenous fistulae.


OBJECTIVE
To evaluate the primary patency of arteriovenous fistulae following percutaneous transluminal angioplasty.


METHODS
Patients submitted to percutaneous transluminal angioplasty in the Angiology service of Hospital de Base in 2004 were analyzed over an average follow-up of 10 months (2 to 16 months).


RESULTS
A total of 22 angioplasties were performed in 20 fistulae of 19 patients. Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae. The following complications occurred in the remaining 18 fistulae, three deaths with two fistulae patent until death; one exeresis of prosthesis due to infection (53 days after the procedure); two thromboses (3 and 49 days after the procedure) and four restenosis (3 were submitted to a second angioplasty and one treated surgically). At the end of the follow-up, 11 fistulae (55%) were patent and with a flow rate in hemodialysis > 300 mL/min. Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.


CONCLUSIONS
Percutaneous transluminal angioplasty is an efficacious method for the correction of stenosis of arteriovenous fistulae for hemodialysis, prolonging the patency of the fistula and enabling new interventions.
Miquelin
Daniel Gustavo
DG
Livre Docente of the Cardiology and Cardiovascular Surgery Department of the Medical School in São José do Rio Preto (FAMERP), Professor of the Graduation and post graduation courses of FAMERP and CNPq researcher, Brazil. godoyjmp@riopreto.com.br.
Reis
Luis Fernando
LF
da Silva
Adinaldo Adhemar Menezes
AA
de Godoy
José Maria Pereira
JM