New office-based vascular interventions.
OBJECTIVE
Following contemporary trend, various vascular interventions being performed in the office. We describe our office experience with radiofrequency ablation (RFA) of incompetent perforating veins (IPV) and duplex-guided balloon angioplasties of failing/nonmaturing arterio-venous fistulas (AVF). DUPLEX-GUIDED BALLOON ANGIOPLASTIES OF AVF: Eighteen patients with 20 failing arterio-venous (AV) fistulas underwent office duplex-guided balloon angioplasties. Thirteen procedures (65%) were on non-maturing fistulas and the remaining 7 (35%)--in dialyzed patients. Sheath insertion, wire and balloon passage and inflation were guided by duplex only.
We performed 25 radiofrequency ablations of 49 IPVs. Early follow-up scan confirmed total occlusion of 45 (92%) treated IPVs. Patients gender, CEAP class, perforator diameter or GSV patency did not correlate with current procedure failure.


CONCLUSIONS
Excellent duplex imaging quality and technical advances in endovascular tools allowed us safely perform AVF balloon angioplasties and RFA of IPVs in the office.
Marks
Natalie
N
Maimonides Medical Center, Division of Vascular Surgery, Brooklyn, New York 11219, USA. nmarks@maimonidesmed.org
Hingorani
Anil
A
Ascher
Enrico
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D017211:Treatment Failure; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional / Q000379:methods*; D014654:Vascular Patency; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*