scholarly journals Ultrasound-guided cradle-like infiltrative anesthesia for percutaneous transluminal angioplasty of stenotic autogenous arteriovenous hemodialysis access

2021 ◽  
Author(s):  
Mingxi Lu ◽  
Huiying Yang ◽  
Weiwei Xi ◽  
Xuming Zhao ◽  
Hua Li
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Hemodialysis Access ◽  
Ultrasound Guided ◽  
Percutaneous Transluminal

Arterial percutaneous angioplasty in hemodialysis access: Endovascular treatment of hand ischemia

2020 ◽  
pp. 112972982094665
Author(s):  
Gabriela Teixeira ◽  
Paulo Almeida ◽  
Luís Loureiro ◽  
Inês Antunes ◽  
Duarte Rego ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Clinical Success ◽  
Invasive Procedure ◽  
Transluminal Angioplasty ◽  
Arterial Stenosis ◽  
Low Flow ◽  
Hemodialysis Access ◽  
Percutaneous Transluminal

Background: Hemodialysis access–induced distal ischemia consists of symptomatic extremity malperfusion after vascular access creation. It is usually caused by discordant vascular resistance, with arteriovenous shunting of a high blood volume from arterial into venous system and subsequent hand hypoperfusion. Less often, hemodialysis access–induced distal ischemia is caused by arterial stenosis. In these cases, access frequently has normal/low flow, radial pulse is usually absent and not recoverable with vascular access digital compression, diabetes is often present, and percutaneous transluminal angioplasty can be critical for access and limb salvage. Methods: Retrospective study conducted between June 2011 and February 2018 of patients with vascular access submitted to arterial percutaneous transluminal angioplasty for limb-threatening ischemia. Results: Twenty-nine patients were referred for arterial angiography after hemodialysis access–induced distal ischemia diagnosis and physical examination or ultrasound findings suggestive of arterial disease. In 11 patients, percutaneous transluminal angioplasty was not technically feasible. Among 18 treated patients, 83.3% had diabetes and 60% had skin ulcerations. Target arteries were radial (11), brachial (7), axillar (2), ulnar (2), and subclavian (1). Clinical success, defined as arteriovenous maintenance and wound healing/pain resolution, was observed in 12 patients (66.7%). Concomitant procedures included adjuvant banding ( n = 2) and finger amputation ( n = 1), and one reintervention was performed. No intra- or postoperative complications were reported. Conclusion: Hemodialysis access–induced distal ischemia is a serious complication of hemodialysis vascular access, with multifactorial etiology. Correct and timely diagnosis is crucial for maintaining access and limb salvage. Percutaneous transluminal angioplasty is a minimally invasive procedure that may be effective and long-lasting in carefully selected patients with ischemic complaints.

Hemodialysis Access Graft Stenosis: Percutaneous Transluminal Angioplasty

1997 ◽  
Vol 68 (2) ◽  
pp. 181-185 ◽  
Author(s):  
A.B. Lumsden ◽  
M.J. Macdonald ◽  
D.K. Kikeri ◽  
L.A. Harker ◽  
R.C. Allen
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Hemodialysis Access ◽  
Graft Stenosis ◽  
Percutaneous Transluminal ◽  
Access Graft
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