Elevation transposition method for superficialization of the basilic vein achieves better patency rate than tunnel transposition

Background Endovascular treatment is a first-line treatment for upper thoracic central vein obstruction (CVO). Few studies using bare venous stents (BVS) in CVO have been conducted. Purpose To evaluate the treatment performance of upper thoracic central vein stenosis between BVS and conventional bare stent (CBS) in hemodialysis patients. Methods Hemodialysis patients with upper thoracic central vein obstruction who underwent endovascular treatment at the interventional unit of our institution from 1 January 2008 to 31 December 2018 were enrolled in the present study. CBS was used to treat central vein obstruction in 43 patients and BVS in 34 patients. We compared the primary patency rates and complications between the two stent types. P values < 0.05 were considered statistically significant. Results The patient demographic data between the CBS and BVS groups were similar. The characteristics of the lesions, procedures, and complications were not significantly different between the two groups ( P > 0.05). There were no statistically significant differences of primary patency rates at three and six months between the BVS and CBS groups (94.1% vs. 86.0% and 73.5% vs. 58.1%, respectively; P > 0.05). The primary patency rate at 12 months in the BVS group was significantly higher than that in the CBS group (61.8% vs. 32.6%; P = 0.008). Conclusion Endovascular treatment of central vein obstruction with BVS provided a higher primary patency rate at 12 months than CBS.

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Stent patency and outcome of TIPS through the left versus the right portal branches

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00305-z ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Mohamed S. Alwarraky ◽

Hasan A. Elzohary ◽

Mohamed A. Melegy ◽

Anwar Mohamed

Keyword(s):

Portal Hypertension ◽

Clinical Outcome ◽

Portal Vein ◽

Variceal Bleeding ◽

Patency Rate ◽

Hospital Admissions ◽

Stent Patency ◽

Left Branch ◽

The Right

Abstract Background Our purpose is to compare the stent patency and clinical outcome of trans-jugular intra-hepatic porto-systemic shunt (TIPS) through the left branch portal vein (TIPS-LPV) to the standard TIPS through the right branch (TIPS-RPV). We retrospectively reviewed all patients (n = 54) with refractory portal hypertension who were subjected to TIPS-LPV at our institute (TIPS-LPV) between 2016 and 2018. These patients were matched with 56 control patients treated with the standard TIPS-RPV (TIPS-RPV). The 2 groups were compared regarding the stent patency rate, encephalopathy, and re-interventions for 1 year after the procedure. Results TIPS-LPV group showed 12 months higher patency rate (90.7% compared to 73.2%) (P < 0.005). The number of the encephalopathy attacks in the TIPS-LPV group was significantly lower than that of the TIPS-RPV group at 6 and 12 months of follow-up [P = 0.012 and 0.036, respectively]. Re-bleeding and improvement of ascites were the same in the two groups [P > 0.05]. Patients underwent TIPS-LPV needed less re-interventions and required less hospitalizations than those with TIPS-RPV [P = 0.039 and P = 0.03, respectively]. Conclusion The new TIPS approach is to extend the stent to LPV. This new TIPS-LPV approach showed the same clinical efficiency as the standard TIPS-RPV in treating variceal bleeding and ascites. However, it proved a better stent patency with lower rates of re-interventions, encephalopathy, and hospital admissions than TIPS through the right branch.

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Factors associated with infrainguinal bypass graft patency at 1-year; a retrospective analysis of a single centre experience

Perfusion ◽

10.1177/0267659121995760 ◽

2021 ◽

pp. 026765912199576

Author(s):

Pasha Normahani ◽

Ismail Yusuf Anwar ◽

Alona Courtney ◽

Amish Acharya ◽

Viknesh Sounderajah ◽

...

Keyword(s):

Retrospective Analysis ◽

Patency Rate ◽

Bypass Graft ◽

Graft Patency ◽

Primary Patency ◽

Rank Test ◽

Secondary Patency ◽

Factors Associated ◽

Independent Variables ◽

Secondary Patency Rate

Introduction: The aim of this study was to identify factors associated with primary graft patency 1 year following open lower limb revascularisation (LLR) at a tertiary referral vascular service. Methods: A retrospective analysis of patients undergoing infra-inguinal bypass surgery between January 2016 and May 2017 at a tertiary vascular centre (St Mary’s Hospital, London) was performed. Data regarding patient demographics, comorbidities, type of operation and post-operative anti-thrombotic strategy were collected. Quality of run-off score was assessed from pre-operative imaging. Results: Seventy-seven cases were included in the analysis. Overall, the primary patency rate at 1-year was 63.6% ( n = 49/77) and the secondary patency rate was 67.5% ( n = 52/77). Independent variables with statistically significant inferior patency rates at 1-year were (1) bypasses with below knee targets (p = 0.0096), (2) chronic limb threatening ischaemia indication (p = 0.038), (3) previous ipsilateral revascularisation (p < 0.001) and (4) absence of hypertension history (p = 0.041). There was also a trend towards significance for American Society of Anesthesiologists (ASA) grade (p = 0.06). Independent variables with log-rank test p values of <0.1 were included in a Cox proportional hazards model. The only variable with a statistically significant impact on primary patency rates was previous open or endovascular ipsilateral revascularisation (HR 2.44 (1.04–5.7), p = 0.04). Conclusion: At 1-year follow-up, previous ipsilateral revascularisation was the most significant factor in affecting patency rates. Patients in this subgroup should therefore be deemed high-risk, which should be reflected in the informed consent and peri-operative management.

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Combined transposition of brachial and basilic vein: Response to “Percutaneous creation of proximal radio-radial arteriovenous hemodialysis fistula before secondary brachial vein elevation. J Vasc Access. 2020; doi: 10.1177/1129729820936921”

The Journal of Vascular Access ◽

10.1177/1129729821989163 ◽

2021 ◽

pp. 112972982198916

Author(s):

Efstratios Georgakarakos ◽

Christodoulos Keskinis ◽

Aliki Fiska

Keyword(s):

Basilic Vein ◽

Hemodialysis Fistula ◽

Brachial Vein

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POS-590 CLINICAL PREDICTORS OF RECURRENT CEPHALIC ARCH STENOSIS AND IMPACT OF THE ACCESS FLOW REDUCTION ON THE PATENCY RATE

Kidney International Reports ◽

10.1016/j.ekir.2021.03.619 ◽

2021 ◽

Vol 6 (4) ◽

pp. S259

Author(s):

Y. KIM ◽

H.D. Kim ◽

B.H. Chung ◽

C.W. Park ◽

C.W. Yang ◽

...

Keyword(s):

Patency Rate ◽

Clinical Predictors ◽

Flow Reduction

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Effects of plasma atherogenic index and plasma osmolality on arteriovenous fistula patency in hemodialysis patients

The Journal of Vascular Access ◽

10.1177/11297298211011864 ◽

2021 ◽

pp. 112972982110118

Author(s):

Cengiz Güven ◽

Arda Aybars Pala ◽

Yusuf Salim Urcun

Keyword(s):

Renal Failure ◽

Arteriovenous Fistula ◽

Patency Rate ◽

Fasting Blood Glucose ◽

Multivariate Logistic Regression Analysis ◽

Plasma Osmolality ◽

Density Lipoprotein ◽

Atherogenic Index ◽

Diabetic Patients ◽

Digital Medium

Background: The purpose of the present study was to investigate the effects of Plasma atherogenic index (AIP) and plasma osmolality (PO) values on arteriovenous fistula (AVF) patency in patients with chronic renal failure. Methods: The patients with primary AVF between December 2012 and March 2020 with the diagnosis of end-stage renal disease in our clinic were included in the study. The patient data were collected retrospectively in digital medium. Diabetic patients were not included in the study. The Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), sodium (Na), fasting blood glucose, and blood urea nitrogen (BUN) values were found and recorded from the files. AIP and PO were calculated with special formulas. Fistula patency rate in 6th, 12th, and 24th months were evaluated in 2-year follow-ups. Results: According to the results of two-year follow-ups of the 162 patients, who underwent primary AVF, 21 (13%) patients were found to have thrombosis in the 6th month, 33 (20.4%) patients in the 12th month; however,141 (87%) and 129 (79.6%) patients actively used AVF in the 6th and 12th months, respectively. The AIP and PO values that were calculated in the patient group with AVF thrombosis were significantly higher ( p = 0.001, p < 0.001; respectively). In the multivariate logistic regression analysis, Na, BUN, and HDL-C variables were found to be independent predictive factors for AVF thrombosis (OR (Odds Ratio): 1.169, 95% CI (Confidence interval)): 1.056–1.294, p = 0.003; OR: 1.108, 95% CI: 1.043–1.176, p = 0.001; OR: 0.874, 95% CI: 0.820–0.932, p < 0.001; respectively). It was also found that the patency rate was 64.2% (104 patients) in the 24th month. Conclusion: AIP, PO, Na, and BUN values are positively associated with AVF thrombosis. Checking AIP, Na, and BUN values will be useful in patients with end-term renal failure, who already have difficulties in renal replacement methods and vascular access.

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Self-Expanding Nitinol Stent vs Percutaneous Transluminal Angioplasty in the Treatment of Femoropopliteal Lesions: 3-Year Data From the SM-01 Trial

Journal of Endovascular Therapy ◽

10.1177/1526602819826591 ◽

2019 ◽

Vol 26 (2) ◽

pp. 158-167 ◽

Cited By ~ 7

Author(s):

Osamu Iida ◽

Kazushi Urasawa ◽

Yasuo Komura ◽

Yoshimitsu Soga ◽

Naoto Inoue ◽

...

Keyword(s):

Percutaneous Transluminal Angioplasty ◽

Patency Rate ◽

Velocity Ratio ◽

Peak Systolic Velocity ◽

Transluminal Angioplasty ◽

Primary Patency ◽

Stent Group ◽

Primary Patency Rate ◽

Multicenter Randomized Controlled Trial ◽

Percutaneous Transluminal

Purpose: To report the midterm outcomes of a trial comparing self-expanding nitinol stents to percutaneous transluminal angioplasty (PTA) with provisional stenting in the treatment of obstructive disease in the superficial femoral and popliteal arteries. Materials and Methods: The SM-01 study ( ClinicalTrials.gov identifier NCT01183117), a single-blinded, multicenter, randomized controlled trial in Japan, enrolled 105 consecutive patients with de novo or postangioplasty restenotic femoropopliteal lesions; after removing protocol violations (1 from each group), 51 patients (mean age 74±8 years; 36 men) in the stent group and 52 patients (mean age 73±8 years; 35 men) in the PTA group were included in the intention-to-treat analysis. The groups were well-matched at baseline. Patients were followed to 36 months with duplex imaging. Three-year primary patency was assessed based on a duplex-derived peak systolic velocity ratio <2.5. Freedom from clinically-driven target vessel revascularization (TVR) and target lesions revascularization (TLR) were estimated using the Kaplan-Meier method. Results: The technical success rate was higher (100% vs 48%, p<0.001) and the frequency of vascular dissection was lower (4% vs 31%, p<0.001) in the stent group. The S.M.A.R.T stent group had a higher 3-year primary patency rate (73% vs 51%, p=0.033). Freedom from clinically-driven TVR and TLR were not significantly different between the groups. Conclusion: The S.M.A.R.T. stent maintained a higher primary patency rate than PTA at 3 years in this randomized trial; the need for clinically-driven revascularization was similar for both therapies.

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