ABSTRACT
PURPOSE: Many studies show the important factors for better patency rate of the arteriovenous patients. accoding the former articles, age, the site of artery, the presence of diabete or hypertension and the BUN and creatinine level are most important factors. In this article is willing to identify factors that may influence the patency rate of arteriovenous fistulae. METHOD: 125 consecutive patients who underwent internal arteriovenous fistula formation in chonnam national university during 18 months from 1997 to 1998 were reviewed and analyzed. The analyzing factors were age, sex, presence of DM, and hypertension, the level of BUN, Creatinine. RESULT: Overall patency rates of upper arm arteriovenous fistular were 73.3% at one year and 71.5% at the end of two year. BUN level at the time of the fistula formation was another significant factor, and one year patency rates of the groups with BUN less than 50 mg/dL, BUN between 50 and 99 mg/dL, and BUN over 100 mg/dL were, 50.4%, 64.8% and 87.5% respectively, and these differences continued at least for 30 months after the fistular creation (P=0.046). Serum creatinine level also had close relationship with patency and one year patency rate of group with serum creatinine levels less than 5 mg%, 5-9.9 mg%, over the 10 mg% were, 48.5%, 67.5% and 84.5% respectively (P=0.014) Differences in patency rates were also noted according the presence of diabete mellitus (P=0.0397) and the hypertension (P=0.0424) Age is also meaningful factor and significant in this study. CONCLUSION: Among the suspected factors that may influence the patency of fistula, BUN, serum creatinine, and the presence of DM or hypertension were statistically significant on multivariant analysis.
Subject(s)
Humans , Arm , Arteries , Arteriovenous Fistula , Creatinine , Fistula , HypertensionABSTRACT
PURPOSE: To evaluate the usefulness of placement of self-expandable stents in hemodialytic shunt-relatedsubclavian vein stenosis. MATERIALS AND METHODS: Self-expandable metallic stent was placed in nine patients withhemodialytic shunt-related subclavian vein stenosis. In seven cases, angioplasty was attempted before stentplacement; in five, stents were placed immediately after failed angioplasty; and in two, due to restenosis afterangioplasty. Procedures involved a 10mm diameter, 7-10cm length Wallstent in eight cases, and a 10mm diameter, 8cm length Hanaro stent in one. In all cases, clinical follow-up, which included physical examination and themeasurement of venous resistance pressure during hemodialysis, was performed. The follow-up period was between 5months and 1 year 7 months. Repeated intervention was performed if restenosis was detected. RESULTS: The stenoticsites were in eight cases the site of a previous subclavian venous line, and in one, the site of anatomicnarrowing at the thoracic inlet of the subclavian vein. The technical success rate was 100%; a resultingcomplication was stent migration into the right atrium in one case in which a Hanaro stent had been used; this wasremoved by snaring. During follow-up of the eight patients in whon stent placement was successful, restenosisdeveloped in three cases. This occurred during the 7th, 8th, and 15th month, respectively. Two such cases weretreated by balloon dilatation. CONCLUSION: In hemodialytic shunt-related subclavian vein stenosis, treatmentinvolving the use of a self-expandable metallic stent is useful, especially for treating a lesion which has notresponded to angioplasty with a high patency rate.
Subject(s)
Humans , Angioplasty , Bays , Constriction, Pathologic , Dilatation , Follow-Up Studies , Heart Atria , Physical Examination , Renal Dialysis , SNARE Proteins , Stents , Subclavian Vein , VeinsABSTRACT
No abstract available.