Predictors of primary patency after percutaneous balloon angioplasty for stenosis of Brescia-Cimino hemodialysis arteriovenous fistula
| Autor: | Jian-Qiang Cao, Tan Yanhong, Guo-jian Xu, Jia-Yu Wu, Xiao-Xia Liang, Zhi-Jian He, Zheng-Rong Zhu, Yu-can Tan, Can-hua Luo, Hui-Ping Zhang, Lan Zou, Yue Xing |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Treatment outcome Constriction Pathologic 030204 cardiovascular system & hematology Percutaneous transluminal balloon angioplasty 030218 nuclear medicine & medical imaging Constriction 03 medical and health sciences Arteriovenous Shunt Surgical 0302 clinical medicine Renal Dialysis Angioplasty medicine Humans Radiology Nuclear Medicine and imaging Vascular Patency Aged Aged 80 and over Full Paper business.industry Endovascular Procedures Graft Occlusion Vascular Percutaneous balloon angioplasty General Medicine Middle Aged medicine.disease Surgery Stenosis Equipment failure Treatment Outcome Equipment Failure Female Hemodialysis - arteriovenous fistula business Angioplasty Balloon |
| Zdroj: | Br J Radiol |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.20190505 |
| Popis: | Objective: Percutaneous transluminal balloon angioplasty (PTA) is recommended as the first choice to treat stenosis of Brescia-Cimino arteriovenous fistulas (B-C AVFs). The ability to predict which B-C AVFs are at risk for recurrent stenosis post-PTA would allow closer monitoring of patients, and possibly result in surgical intervention rather than repeat PTA. The purpose of this study was to identify predictive factors of primary patency after PTA in B-C AVFs. Methods: Patients diagnosed with B-C AVF primary stenosis and treated by PTA between November 2013 and March 2018 were included in the study. Patient and stenotic lesion characteristics and PTA procedure factors were included in the analysis. The Kaplan–Meier method was used to analyze the primary patency rate. Cox proportional hazard regression analysis was used to identify factors predictive of decreased primary patency. Results: 74 patients (35 males, 39 females) with a mean age of 61.68 ± 11.44 years (range, 36–84 years) were included in the study. The mean B-C AVF age was 16.34 ± 12.93 months (range, 2–84 months), and the median primary patency time was 7.79 ± 0.48 months. Cox proportional hazard regression analysis revealed stenosis location at the inflow artery [hazard ratio (HR)=3.83, 95% confidence interval (CI): 1.46–10.09] or anastomosis (HR = 1.90, 95% CI: 1.09–3.32), dilation >2 times during PTA (HR = 2.30, 95% CI: 1.22–4.34), and residual stenosis >30% (HR = 2.42, 95% CI: 1.26–4.63) were significantly associated with decreased patency. Conclusion: In conclusion, the primary patency rate of PTA for B-C AVF dysfunction is reduced by dilation >2 times, residual stenosis >30%, and stenosis located at the inflow artery or anastomosis. These results may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with AVF dysfunction. Advances in knowledge: A number of studies have been conducted to examine the predictors of primary patency after PTA, however, no definitive conclusions have been reached. Our study revealed that stenosis location at the inflow artery or anastomosis, dilation >2 times during PTA, and residual stenosis >30% were the predictors of primary patency after PTA, which may help in tailoring surveillance programs, multiple PTA, or a proximal re-anastomosis surgery in patients with arteriovenous fistulas dysfunction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|