title: Ultrasound-guided endovascular treatment for vascular access malfunction: results in 4896 cases.
abstract: OBJECTIVE
  For the protracted maintenance of vascular access, countermeasures against stenosis are important. Between March 2004 and October 2011 superficial ultrasound-guided percutaneous transluminal angioplasty (PTA) was performed in our hospital for arteriovenous fistula malfunction in 4869 cases in 1011 patients, and the utility of the treatment was assessed on the basis of early results. In cases where vascular intervention was deemed necessary, the procedure was conducted under ultrasound guidance as first option, with fluoroscopy and radiography used additionally as necessary.
  
  
  METHODS
  The ultrasound apparatus used was primarily the 11 MHz linear-type probe (GE-Yokogawa Logiq S6). For subclavian and brachiocephalic veins, the microconvex-type probe was used to visualize the lesion through the intercostal space. In obstruction cases, ultrasound-guided PTA was performed after superficial ultrasound-guided aspiration or thrombus removal.
  
  
  RESULTS
  In stenosis cases, early success (technical and clinical) was obtained in 4288 of 4414 cases (97.1%). In obstruction cases, early success was obtained in 443 cases and 91.9% for obstruction cases. Assistance by intra-operative fluoroscopy or radiography was required in 55 cases, and surgical reconstruction was required in 42 cases. Serious complications occurred in 12 of 4869 cases (0.2%).
  
  
  CONCLUSIONS
  Ultrasound-guided PTA for arteriovenous fistula malfunction could be used as a substitute for fluoroscopy-guided PTA, and enables the use of safe and rapid intervention techniques.
authors: Department of Vascular Surgery, Bousei The First Clinic, Numadu, Shizuoka - Japan.
authors: Masanori
authors: M
authors: Wakabayashi
authors: Sayaka
authors: S
authors: Hanada
authors: Hiroyuki
authors: H
authors: Nakano
authors: Tsunemichi
authors: T
authors: Wakabayashi
mesh_terms: D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003251:Constriction, Pathologic; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D015641:Radiography, Interventional; D019651:Plastic Surgery Procedures; D006435:Renal Dialysis; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional