Efficacy of Percutaneous Transluminal Angioplasty for Treating Non-Maturing Brescia-Cimino Fistulas

ABSTRACT

PURPOSE: We wished to report our experiences for the treatment of non-maturing Brescia-Cimino fistulas by using percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: From January 1997 and December 2003, we treated 22 patients with non-maturing Brescia-Cimino fistulas by using percutaneous transluminal angioplasty (PTA). A retrospective analysis was performed on the findings of the fistulograms, techniques and success rate of the PTA, and the patency rate. RESULTS: Seventeen segmental stenoses and 5 segmental occlusions of the cephalic veins were identified. Sixteen stenoses and 2 occlusions were located at the cephalic vein adjacent to the anastomosis site, and 3 occlusions and 1 stenosis are seen at the proximal vein near the elbow joint. In addition to venous stenosis, a focal arterial stenosis at the anastomosis site and two accompanying accessory veins that might hamper the maturation of main cephalic vein was seen in each of two patients, respectively, and the simultaneous occlusion of the left innominate vein as well as occlusion of the cephalic vein was noted in one patient. The initial success rate of the PTA procedures was 95.5% (21/22). The overall success rate including the 11 additional PTAs that were performed during follow-up was 96.9% (32/33). No major complication were noted to have occurred. The primary and secondary patency rates were 72% (16/22) and 95% (21/22) at 3 months, and 50% (11/22) and 77% (17/22) at 6 months, respectively. CONCLUSION: PTA is an effective and safe method for treating non-maturing Brescia-Cimino fistulas.