Management of Postbiopsy Arteriovenous Fistulas in Transplanted Kidneys and Effectiveness of Endovascular Treatment: A Single-center Experience
| Autor: | Giuseppe Parziale, Paolo Cerini, Marco Quaglia, Giuseppe Guzzardi, Alessandro Carriero, Ivan Di Gesù, Rita Fossaceca, Emanuele Malatesta |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Time Factors Biopsy medicine.medical_treatment Kidney Single Center Asymptomatic chemistry.chemical_compound Humans Medicine cardiovascular diseases Embolization Kidney surgery Ultrasonography Doppler Color Endovascular treatment Kidney transplantation Aged Asymptomatic Diseases Creatinine business.industry Endovascular Procedures General Medicine Middle Aged medicine.disease Embolization Therapeutic Kidney Transplantation Surgery Treatment Outcome Italy chemistry Arteriovenous Fistula Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Annals of Vascular Surgery. 28:452-456 |
| ISSN: | 0890-5096 |
| Popis: | Background We sought to evaluate the best therapeutic management of postbiopsy arteriovenous fistulas (AVFs) in transplanted kidneys. Methods Between January 2005 and December 2011, we observed 17 cases of postbiopsy AVF in transplanted kidneys (9 asymptomatic; 8 symptomatic). Asymptomatic cases were managed conservatively, while patients with symptomatic AVF underwent endovascular treatment. We used a technique that consisted in a superselective transcatheter embolization of the afferent branch. We evaluated the technical success (postoperative closure of AVF), the immediate clinical efficacy (cessation of symptoms), and clinical efficacy at follow-up (measurement of serum creatinine at 7 days and 6 and 12 months compared with preoperative levels using t -tests). Results Asymptomatic AVFs resolved spontaneously, while the endovascular treatment in symptomatic AVFs showed a complete technical and clinical success with prompt remission of the presented symptoms. We observed a statistically significant reduction in serum creatinine at 7 days and 6 and 12 months postoperatively (mean creatinine—preoperative: 3.23 ± 1.4 mg/dL; 7 days: 2.25 ± 0.8 mg/dL; 6 months: 1.65 ± 0.28 mg/dL; 12 months: 1.4 ± 0.26 mg/dL; in all cases P Conclusions In our experience, asymptomatic AVFs could be managed conservatively with close follow-up while the endovascular treatment for symptomatic AVFs is both safe and effective in the short- and long-term. |
| Databáze: | OpenAIRE |
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