Treatment of venous outflow stenosis in hemodialysis arteriovenous fistulae using percutaneous transluminal angioplasty: our experience at King Hussein medical center

To evaluate the technical success and primary patency of percutaneous transluminal angioplasty as a modality of treatment for outflow venous stenosis in arteriovenous fistulae used as hemodialysis access. This is a retrospective, single center review which was conducted between August 2008 to August 2009, analyzing the results of percutaneous transluminal angioplasty used to treat 49 patients with short segment venous outflow stenosis. Patency was assessed by clinical examination and Doppler ultrasound scanning over a follow up period of one year. The immediate technical success rate of percutaneous transluminal angioplasty was 98%. The primary patency at six months, and one year were 83% and 53% respectively. One patient developed rupture of the vein at the site of angioplasty. Six patients died during the follow up period. The deaths were not related to the procedure or access failure. Percutaneous transluminal angioplasty is an effective method for treatment of venous outflow stenosis in surgically created arteriovenous fistulae, with excellent technical success, acceptable one year primary patency, and low complications rate

Results of vascular clip closure device at King Hussein medical center

To assess the results of vascular clip closure devices used following percutaneous transfemoral endovascular procedures. This is a retrospective review of 69 patients who were managed with vascular clip closure device following transfemoral peripheral endovascular interventions during the year 2009, at King Hussein Medical Center. The success of the device in achieving hemostasis, as well as the associated complications were evaluated. Technical success defined as successful deployment of the device was achieved in 65 patients. Two minor complications and one major complication occurred following the deployment of the device. Femoral arterial access clip closure devices are both safe and effective, and are advised to be used in patient at high risk of bleeding at the arterial access site

Percutaneous transluminal angioplasty of popliteal artery steno-occlusive atherosclerotic disease at the king Hussein medical center: two year primary patency

To evaluate the two year primary patency following the percutaneous transluminal angioplasty [PTA] used to treat popliteal artery steno-occlusive atherosclerotic disease in the King Hussein Medical Center [KHMC]. A retrospective single-center study, analyzing the patency of 92 PTA procedures of the popliteal artery performed in 86 patients. Follow up patency was assessed by clinical examination, the ankle-brachial pressure index, and color duplex scanning over two years. Two year primary patency following popliteal artery PTA was 76% for stenotic lesions versus 37% for occlusive lesions. There was no procedure related periprocedural mortality. Popliteal artery PTA is performed effectively in the KHMC for patients with disabling intermittent claudication and critical lower limb ischemia with better results in stenotic lesions in comparison to occlusive lesions