Percutaneous transluminal angioplasty of a non-mainstream venous route to restore an occluded hemodialysis fistula

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• 作者：Shiro Miyayama (1)
  Masashi Yamashiro (1)
  Masaya Ikuno (1)
  Kenichiro Okumura (1)
  Miki Yoshida (1)
  Tamayo Kato (2)
  Yasuyuki Ushiogi (2)
  
• 关键词：Native hemodialysis fistula ; Percutaneous transluminal angioplasty ; Non ; mainstream venous route
• 刊名：Japanese Journal of Radiology
• 出版年：2014
• 出版时间：February 2014
• 年：2014
• 卷：32
• 期：2
• 页码：117-122
• 全文大小：516 KB
• 作者单位：Shiro Miyayama (1)
  Masashi Yamashiro (1)
  Masaya Ikuno (1)
  Kenichiro Okumura (1)
  Miki Yoshida (1)
  Tamayo Kato (2)
  Yasuyuki Ushiogi (2)
  
  1. Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan
  2. Department of Internal Medicine, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan
  
• ISSN：1867-108X

文摘

Purpose To report the usefulness of percutaneous transluminal angioplasty (PTA) of a non-mainstream venous route in an occluded native hemodialysis fistula when a mainstream outflow vein could not be traversed. Materials and methods This cohort included seven patients with an occulted hemodialysis fistula with difficulty in traversing via a mainstream route. A non-mainstream vein near the occluded portion was traversed until it connected with a proximal large-sized vein and the route was dilated using a 4- or 5-mm balloon catheter. Metallic stent placement was performed, if necessary. Technical aspects and long-term patency was evaluated. Results PTA could be performed in all patients; however, stent placement was required in two because of residual stenosis and clotting. The clinical success rate of fistula restoration was 100?%. Fistula dysfunction recurred in six patients 17-68?days (mean?±?standard deviation 229.3?±?225.0) later. PTA was repeated in four patients, but not in two. The mean duration of the primary patency was 336.6?±?417.2?days (range 17-,190) and that of the secondary patency was 897.1?±?801.4?days (range 17-,230). Conclusion PTA of a non-mainstream venous route is useful for restoring an occluded hemodialysis fistula when the mainstream outflow vein cannot be traversed.