Balloon angioplasty: A promising adjunct to arteriovenous fistula creation compared with hydrostatic dilatation in small-caliber cephalic veins
Autor: | Ranjith Kumar Anandasu, Chandrasekhar A Ramswamy, Luv Luthra, Rajendra Prasad Basavanthappa, Adarsh K Maradupandian, Sanjay C Desai, Vivek Vardhan Jayaprakash, Santosh K Tiwari, Ashwini Naveen Gangadharan |
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Rok vydání: | 2021 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Time Factors medicine.medical_treatment Arteriovenous fistula Balloon End stage renal disease Arteriovenous Shunt Surgical Renal Dialysis Angioplasty medicine Humans Dialysis Vascular Patency business.industry General Medicine Venous Segment medicine.disease Dilatation Surgery Treatment Outcome Arteriovenous Fistula Hemodialysis Cardiology and Cardiovascular Medicine business Angioplasty Balloon Kidney disease |
Zdroj: | Asian cardiovascularthoracic annals. 30(5) |
ISSN: | 1816-5370 |
Popis: | Background To maintain the patency and longevity of arteriovenous fistula, the availability of a venous segment with adequate diameter is important. In Indian population, many chronic kidney disease patients have poor caliber veins. The study aimed to evaluate the efficacy of hydrostatic dilatation versus Primary balloon angioplasty of small caliber cephalic veins of (≤2.5 mm) preoperatively in terms of patency rate and maturation time of arteriovenous fistula. Methods Patients ( n = 80) with an end-stage renal disease requiring arteriovenous access surgery for hemodialysis with small caliber cephalic veins were randomized into two groups, i.e., hydrostatic dilatation and primary balloon angioplasty, each with 40 patients. All patients underwent a thorough clinical examination as well as duplex ultrasound vein mapping of both upper extremities. Patients were followed up for six months and primary patency, maturation time, and complications were noted. Results Immediate technical success with good palpable thrill was achieved in 97.5% of patients in the primary balloon angioplasty group and 87.5% in the hydrostatic dilatation group. The fistula maturation time in the primary balloon angioplasty group was 34.41 days and 46.18 days in the hydrostatic dilatation group. In the primary balloon angioplasty group, the primary patency of the fistula was 97.5% and 87.5% in the hydrostatic dilatation group, at six months. The arteriovenous fistula functioning rate was 77.5% in the hydrostatic dilatation group as compared to 92.5% in the primary balloon angioplasty group at six months. The incidence of surgical site infection was 5% in the primary balloon angioplasty group as compared to 10% in the hydrostatic dilatation group. Conclusion Primary balloon angioplasty of small caliber cephalic veins (≤2.5 mm) performed prior to arteriovenous fistula creation for hemodialysis is a beneficial procedure. |
Databáze: | OpenAIRE |
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