Percutaneous transluminal angioplasty for Brescia-Cimino hemodialysis fistula dysfunction: technical success rate, patency rate and factors that influence the results

Background: Ensuring graft survival in renal transplant patients is of paramount importance. Early detection and treatment of complications such as transplant renal artery stenosis (TRAS) are essential. Purpose: To evaluate the technical and clinical success rate of renal transplant patients with stenosis in the transplant renal artery or in the iliac artery after percutaneous transluminal angioplasty (PTA). Material and Methods: PTA was carried out on 24 patients with TRAS or iliac artery stenosis. Altogether, 28 stenoses were treated with PTA. The immediate technical result and the clinical outcomes after 1 and 3 months were assessed as well as clinical adverse events. A reduction in serum creatinine and/or a reduction in the number of antihypertensive drugs were criteria for clinical success. Results: The immediate technical success rate after PTA was 93%. The clinical success rate after 1 month was 58%, increasing to 75% after 3 months. Conclusion: The technical success rate is not equivalent to the clinical success rate when treating TRAS with PTA. Furthermore, there is a delay in clinical response, sometimes of 3 months, after a technically successful PTA.

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Percutaneous Aspiration Thrombectomy for Arterial Thromboembolic Occlusion Following Percutaneous Transluminal Angioplasty: Technical Success Rates and Clinical Outcomes

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/a-1652-1726 ◽

2021 ◽

Author(s):

Andreas Schicho ◽

Wolf Bäumler ◽

Niklas Verloh ◽

Lukas Philipp Beyer ◽

Wilma Schierling ◽

...

Keyword(s):

Clinical Outcome ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Thromboembolic Complications ◽

Success Rates ◽

Technical Success ◽

Percutaneous Aspiration ◽

Aspiration Thrombectomy ◽

Technical Success Rate ◽

Percutaneous Transluminal

Purpose We aimed to analyze the technical success rate of manual percutaneous aspiration thrombectomy (PAT) in patients with peripheral arterial thromboembolism as a complication of infrainguinal percutaneous transluminal angioplasty (PTA) and we sought to evaluate the 30-day postintervention clinical outcome. Materials and Methods We retrospectively identified 29 patients (men/women, 18/11; mean age, 74 years) who underwent infrainguinal PAT to treat thromboembolic complications of infrainguinal PTA. Primary and secondary technical successes were defined as residual stenosis of < 50 % of the vessel diameter after PAT alone and PAT with additional PTA, respectively. Clinical outcome parameters (e. g., amputation, need for further intervention) were evaluated during the first 30 days after intervention. Results The primary and secondary technical success rates were 58.6 % (17/29) and 79.3 % (23/29), respectively. Clinical outcome data were available for 93.1 % (27/29) of patients. No further intervention was required within 30 days in 81.5 % (22/27) of patients. Four patients underwent minor amputations owing to preexisting ulcerations (Rutherford Category 5), and no patients underwent major amputations (Rutherford Category 6). Revascularization of the previously treated vessel segment with PTA was necessary on the first postintervention day in one patient. Conclusion Manual PAT, with PTA if needed, has a good technical success rate and satisfactory early clinical outcome in patients with iatrogenic thromboembolic complications after infrainguinal PTA. Key Points: Citation Format

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Early Detection and Percutaneous Transluminal Angioplasty of Hemodialysis Fistula Stenoses: Correlation withVenous Dialysis Pressure and Urea Recirculation Rate

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1998.39.5.921 ◽

1998 ◽

Vol 39 (5) ◽

pp. 921

Author(s):

Bo Young Ahn ◽

Ha Hun Song ◽

Ki Tae Kim ◽

Seog Hee Park ◽

Kyung Sub Shinn ◽

...

Keyword(s):

Early Detection ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Hemodialysis Fistula ◽

Recirculation Rate ◽

Percutaneous Transluminal

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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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Relationship Between Postoperative Neutrophil–Lymphocyte Ratio and 6-Month Primary Patency of Percutaneous Transluminal Angioplasty in Femoropopliteal disease With Drug-Coated and Uncoated Balloons

Angiology ◽

10.1177/0003319718799589 ◽

2018 ◽

Vol 70 (3) ◽

pp. 244-248 ◽

Cited By ~ 1

Author(s):

Yanhua Zhen ◽

Zhihui Chang ◽

Zhaoyu Liu ◽

Jiahe Zheng

Keyword(s):

Percutaneous Transluminal Angioplasty ◽

Patency Rate ◽

Transluminal Angioplasty ◽

Primary Patency ◽

Primary Patency Rate ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Logistic Analysis ◽

Early Restenosis ◽

Percutaneous Transluminal

We investigated the relationship of postoperative neutrophil–lymphocyte ratio (NLR) with 6-month primary patency of percutaneous transluminal angioplasty (PTA) in femoropopliteal disease using drug-coated balloon (DCB) or uncoated balloon (UCB). This retrospective study included 106 patients who received DCB (n = 44) or UCB (n = 62). The postoperative NLR was lower in the DCB group than that in the UCB group (2.60 vs 3.23; P = .004), and 6-month primary patency rate was significantly higher in DCB group than that in the UCB group (77.3% vs 53.2%; P = .011). Multivariate logistic analysis showed that the postoperative NLR was an independent predictor of 6-month primary patency after PTA in patients with femoropopliteal disease (odds ratio: 1.589, 95% confidence interval: 1.078-2.343; P = .019). The cutoff value of postoperative NLR was 3.05 for prediction of 6-month primary patency, with a sensitivity of 64.1% and specificity of 65.7%. The 6-month primary patency rate in the NLR ≤3.05 group was higher than that in the NLR >3.05 group (75.9% vs 47.9%; P = .003). In conclusion, DCB may improve early primary patency by inhibiting inflammation. A higher postoperative NLR was associated with early restenosis.

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Percutaneous Transluminal Angioplasty in Chronic Total Subclavian Venous Stenosis Using Coronary Guidewire: A Case Report

International Journal of Angiology ◽

10.1055/s-0041-1735207 ◽

2021 ◽

Author(s):

Todung D. A. Silalahi ◽

Christopher S. Suwita

Keyword(s):

Success Rate ◽

Subclavian Vein ◽

Percutaneous Transluminal Angioplasty ◽

Transluminal Angioplasty ◽

Alternative Technique ◽

Stent Deployment ◽

Total Occlusion ◽

Venous Stenosis ◽

Lower Success Rate ◽

Percutaneous Transluminal

AbstractArteriovenous fistula is the best permanent vascular access for hemodialysis (HD). However, in our country, HD catheter in jugular or subclavian vein is more commonly found because our patients prefer to hold HD until the complications are unbearable. The catheter increases risk of venous stenosis on site and in surrounding vessels, resulting in access loss. Percutaneous transluminal angioplasty (PTA), combined with stent deployment, can be utilized as main treatment for such stenosis in subclavian vein. This method dated back to two decades ago with high success rate. Nevertheless, reports or studies of angioplasty in total occlusion are scarce, mainly because of lower success rate and the need of smaller penetrating wire. We describe our experience in performing PTA and stent deployment using coronary wire to penetrate total occlusion in subclavian venous stenosis after vein cannulation. We hope that we can give an alternative technique to avoid surgery in such cases.

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HEMODIALYSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3489 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Amber Malik ◽

Muhammad Tufail ◽

Arz Muhammad

Keyword(s):

Balloon Angioplasty ◽

Percutaneous Transluminal Angioplasty ◽

Patency Rate ◽

Hemodialysis Patients ◽

Transluminal Angioplasty ◽

Central Venous ◽

Central Venous Stenosis ◽

Angioplasty Balloon ◽

Venous Stenosis ◽

Percutaneous Transluminal

Objective: To evaluate the treatment success rate of percutaneous transluminal angioplasty (balloon angioplasty) for peripheral and central venous stenosis in hemodialysis patients. Study Design: Retrospective/observational study. Place and Duration of Study: Department of Cardiology, Shaikh Zayed Hospital Lahore from 1st January 2018 to 30th June 2018. Methods: Thirteen patients of both genders presenting during from two years of hemodialysis failure and ipsilateral arm and neck swelling followed by peripheral and central venous stenosis were included in this study. Patients ages were ranging from 25 to 70 years. Patient’s detailed history including hemodialysis treatment, age, sex, socio-economic status was examined after taking informed consent from the patients. Percutaneous transluminal angioplasty (PTA) was performed at all the patients. Procedural success rate was examined. Results: There were 9 (69.23%) patients were men and rest (13.77%) were women. 5 (38.46%) patients were ages between 25 to 45 years, 6 (46.15%) patients had an ages 46 to 65 years and 2 (15.38%) patients were ages greater than 65 years. 10 (76.92%) had rural residency. 40 % patients had income >30000 PKR. Location and severity of lesions was examined as brachiocephalic vein, subclavian vein, Axillary vein, basilica, cephalic and median cubtal vein in 1,3,2,3,3 and 1 patients respectively. We determine priority patency rate in central lesion PTA was 82.7%, 62% and 38% at 3, 6 and 12 months and priority patency rate in peripheral lesions PTA was 87%, 79.5% and 67.8% at 3, 6 and 12 months. Conclusion: It is concluded that percutaneous transluminal angioplasty (balloon angioplasty) procedure for treatment of central and peripheral venous stenosis in hemodialysis patients was safe and effective with no procedural complications.

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Different risk factors are associated with vascular access patency after construction and percutaneous transluminal angioplasty in patients starting hemodialysis

The Journal of Vascular Access ◽

10.1177/1129729820959934 ◽

2020 ◽

pp. 112972982095993

Author(s):

Mahoko Yoshida ◽

Shigehiro Doi ◽

Ayumu Nakashima ◽

Yasufumi Kyuden ◽

Toru Kawai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Vascular Access ◽

Percutaneous Transluminal Angioplasty ◽

Patency Rate ◽

Transluminal Angioplasty ◽

Primary Patency ◽

Secondary Patency ◽

Primary Patency Rate ◽

Percutaneous Transluminal

Background: The objective of this multicenter, prospective observational study was to determine the factors related to patency rates after construction of vascular access (VA) and the first percutaneous transluminal angioplasty (PTA). Methods: The 24-month primary and secondary patency rates after construction of a radiocephalic arteriovenous fistula (RC-AVF) and arteriovenous graft (AVG) were evaluated using the Kaplan–Meier method and log-rank test. The 12-month post-PTA patency rate was also investigated. A Cox proportional hazard model was used to identify clinical parameters associated with the primary patency rate and the post-PTA patency rate. Results: A total of 611 patients were enrolled in the study. The primary patency rate after VA construction was lower in hemodialysis (HD) patients with an AVG than in those with an AVF. Aging (hazard ratio [HR], 1.02 per 1 year; p < 0.001), female sex (HR, 1.41; p = 0.03), diabetes mellitus (HR, 1.37; p = 0.03), low serum albumin (HR, 0.76 per 1-g/dL decrease; p = 0.02), and use of an erythropoietin-stimulating agent (HR, 1.62; p = 0.02) were risk factors for VA problems. The post-PTA patency rate was associated with aging (HR, 1.02; p < 0.001), diabetes mellitus (HR, 1.49; p = 0.02), polycystic kidney disease (HR, 2.14; p = 0.01), temporary catheter use for initiation of HD (HR, 1.60; p = 0.02), and period from VA construction to use (HR, 0.99; p = 0.04). Conclusion: Although a poor patency rate is commonly associated with advanced age and diabetes, different risk factors affect patency between VA construction and the first PTA.

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X-ray-guided and ultrasound-guided percutaneous transluminal angioplasty to treat arteriovenous fistula dysfunction in hemodialysis patients: A retrospective controlled study

The Journal of Vascular Access ◽

10.1177/11297298211023271 ◽

2021 ◽

pp. 112972982110232

Author(s):

Zhen Gan ◽

Liang Zhou ◽

Xian Wu ◽

Chun-Feng Gu ◽

Xu He ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Percutaneous Transluminal Angioplasty ◽

Clinical Success ◽

Transluminal Angioplasty ◽

Secondary Patency ◽

Technical Success ◽

Ultrasound Guided ◽

X Ray ◽

Significant Difference ◽

Percutaneous Transluminal

Purpose: To compare the safety and efficacy of X-ray-guided and ultrasound-guided percutaneous transluminal angioplasty in treating arteriovenous fistula dysfunction. Materials and methods: Data for 219 patients with arteriovenous fistula dysfunction between January 2016 and December 2018 were retrospectively analyzed. The primary endpoints were technical success, clinical success, and primary patency rates. The secondary endpoints were complications and secondary patency rates. Procedure outcomes and both endpoints were evaluated by propensity score analysis. Results: After the propensity score matching, 73 matched pairs of cases were created with 34 pairs of autogenous arteriovenous fistula cases and 39 pairs of prosthetic arteriovenous graft cases. There was no significant difference between the X-ray-guided and ultrasound-guided group, respectively, regarding the technical success rate (84.9% vs 87.7%, p = 0.630), clinical success rate (98.6% vs 97.3%, p = 0.999), and complications (10.9% vs 5.5%, p = 0.228). Although the 6- and 12-month secondary patency rates for the dialysis access between the two groups had significant difference ( p < 0.05), there was no significant difference in primary and secondary patency curves between the two groups ( p > 0.05). Conclusion: The overall efficacy of ultrasound-guided versus X-ray-guided percutaneous transluminal angioplasty in treating arteriovenous fistula dysfunction might be comparable.

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