Drug eluting balloon angioplasty for assisted maturation of failing fistulae
| Autor: | Alexandros Mallios, Benoit Boura, Jeffrey E. Hull, Myriam Combes, Alessandro Costanzo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Arteriovenous fistula 030204 cardiovascular system & hematology Upper Extremity 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Renal Dialysis Angioplasty Neointima Medicine Humans In patient Vascular Patency Aged Ultrasonography Doppler Duplex Hyperplasia business.industry Angiography Graft Occlusion Vascular Drug-Eluting Stents medicine.disease Surgery Treatment Outcome Nephrology Regional Blood Flow Balloon dilation Radiology business Drug eluting balloon Angioplasty Balloon Blood Flow Velocity |
| Zdroj: | The journal of vascular access. 19(2) |
| ISSN: | 1724-6032 |
| Popis: | Objective: To present our experience of balloon-assisted maturation with drug-eluting balloon dilation in patients with recurrent failing arteriovenous fistulae. Case series: Three patients (all males, mean age 71 years) with a complex history of failed attempts at native fistula creation underwent surgical creation of arteriovenous fistulae. Two patients had a two-stage brachio-brachial fistula and 1 had a brachio-cephalic fistula that also required subsequent elevation. After a few weeks of preserved patency with a thrill detected clinically, all patients had a gradual deterioration of flow manifested with loss of thrill and multiple severely stenotic lesions of neo-intimal hyperplasia seen on duplex ultrasound. All 3 non-maturing native arteriovenous fistulae had 1 or more angioplasties with regular balloons that were initially successful; however, they rapidly deteriorated with a loss of thrill and a recurrence of multiple stenosis. Drug-eluting balloon dilation was used subsequently as a last resort to save these failing fistulae. All procedures were successful with the preservation of patency and adequate fistula flow (>600 mL/min) during the follow-up period (4-8 months, mean 6 months), and all patients received successful dialysis with 2-needle cannulation of their fistulae. There were no adverse events during the study period. Conclusions: Drug-eluting balloon angioplasty was to salvage nonmaturing fistulae with durable results in complex patients where conventional treatment had previously failed. Drug-eluting balloons may provide a useful treatment option for patients prone to multiple access failures due accelerated neo-intimal hyperplasia. |
| Databáze: | OpenAIRE |
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