Transcatheter Thrombolysis with Percutaneous Transluminal Angioplasty Using a Trans-Brachial Approach to Treat Thrombosed Arteriovenous Fistulas
| Autor: | Shukui Wang, Guoping Chen, Liang Chen, Chishing Zee, Jianping Gu, Xu He, Tao Wang, Wensheng Lou, Bihong T. Chen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Clinical Research Renal Dialysis Medicine Vascular Patency Humans Thrombolytic Therapy cardiovascular diseases Aged Retrospective Studies business.industry Angioplasty Graft Occlusion Vascular Thrombosis General Medicine Thrombolysis Vascular surgery Middle Aged medicine.disease Surgery Catheter Stenosis Hemodialysis Units Hospital Treatment Outcome 030220 oncology & carcinogenesis Arteriovenous Fistula Kidney Failure Chronic Female Hemodialysis business |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 1234-1010 |
| Popis: | BACKGROUND Arteriovenous fistulas (AVFs) are used to provide vascular access for hemodialysis in patients with end-stage renal failure. However, stenosis and thrombosis can compromise long-term AVF patency. The objective of this study was to evaluate catheter thrombolysis with percutaneous transluminal angioplasty (PTA), using a trans-brachial approach, for acutely thrombosed AVFs. MATERIAL AND METHODS This retrospective study examined 30 cases of AVF thrombosis treated between January 1, 2015 and January 1, 2017. All patients received transcatheter thrombolysis with PTA using a trans-brachial approach. AVF patency was assessed after 6 months. RESULTS Thrombolysis with PTA was performed at 2 to 72 h after diagnosis of AVF occlusion due to acute thrombosis, and AVF patency was restored in all patients. After 6 months, the primary and secondary patency rates were 76.7% and 93.3%, respectively. For type I stenosis, primary patency was achieved in 10 of 16 patients (62.5%) and secondary patency was achieved in 14 of 16 patients (87.5%). For type II stenosis, primary patency was achieved in 13 of 14 patients (92.9%) and secondary patency was achieved in 14 of 14 patients (100%). Comparing type I and II stenosis, a significant difference was detected in the rates of primary patency (odds ratio=0.909, 95% confidence interval 0.754-1.096, P=0.049), but not secondary patency (P=0.178), after 6 months. CONCLUSIONS Our study provides preliminary evidence that catheter-directed thrombolysis with PTA using a trans-brachial approach can achieve high patency rates when used to treat acutely thrombosed AVFs. |
| Databáze: | OpenAIRE |
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