title: Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?
abstract: OBJECTIVE
  To study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.
  
  
  METHODS
  A prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.
  
  
  RESULTS
  Technical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.
  
  
  CONCLUSIONS
  Technical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.
authors.affiliation: Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada.|Department of Radiology, Providence Hospital and Medical Centers, 16001 W 9 Mile Rd., Southfield, MI, 48075, USA.
authors.forename: Arshdeep
authors.initials: A
authors.lastname: Sidhu
authors.affiliation: Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada.
authors.forename: Kong T
authors.initials: KT
authors.lastname: Tan
authors.affiliation: Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada.
authors.forename: Maxime
authors.initials: M
authors.lastname: Noel-Lamy
authors.affiliation: Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Simons
authors.affiliation: Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada. dheeraj.rajan@uhn.ca.
authors.forename: Dheeraj K
authors.initials: DK
authors.lastname: Rajan
mesh_terms: D017130:Angioplasty / Q000379:methods*; D001164:Arteriovenous Fistula / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*
keywords: Angioplasty; Dialysis fistula; Dialysis graft; Hemodialysis; Technical success