title: Percutaneous intervention in axillary loop-configured arteriovenous grafts for chronic hemodialysis patients.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the fistulographic features of malfunctioning axillary loop-configured arteriovenous grafts and the efficacy of percutaneous interventions in failed axillary loop-configured arteriovenous grafts.
  
  
  METHODS
  Ten patients with axillary loop-configured arteriovenous grafts were referred for evaluation of graft patency or upper arm swelling. Fistulography and percutaneous intervention, including thrombolysis, percutaneous transluminal angioplasty and stent placement, were performed. Statistical analysis of the procedure success rate and the primary and secondary patency rates was done.
  
  
  RESULTS
  Four patients had graft related and subclavian venous stenosis, two patients had graft related stenosis and another four patients had subclavian venous stenosis only. Sixteen sessions of interventional procedures were performed in eight patients (average: 2 sessions / patient) until the end of follow-up. An interventional procedure was not done in two patients with central venous stenosis. The overall procedure success rate was 69% (11 of 16 sessions). The post-intervention primary and secondary patency rates were 50% and 63% at three months, 38% and 63% at six months and 25% and 63% at one year, respectively.
  
  
  CONCLUSIONS
  Dysfunctional axillary loop-configured arteriovenous grafts almost always had subclavian venous and graft-related stenosis. Interventional treatments are helpful to overcome this and these treatments are expected to play a major role in restoring and maintaining the axillary loop-configured arteriovenous loop grafts.
authors.affiliation: Department of Radiology, College of Medicine, Korea University, Seoul 136-705, Korea.
authors.forename: Beom Jin
authors.initials: BJ
authors.lastname: Park
authors.forename: Hyoung Rae
authors.initials: HR
authors.lastname: Kim
authors.forename: Hwan Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Deuk Jae
authors.initials: DJ
authors.lastname: Sung
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Park
authors.forename: Ho Sung
authors.initials: HS
authors.lastname: Son
authors.forename: Sang Kyung
authors.initials: SK
authors.lastname: Jo
authors.forename: Yun Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D016019:Survival Analysis; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency