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Salvage Therapy for a Dysfunctional Arteriovenous Fistula for Hemodialysis
Journal of the Korean Surgical Society ; : 378-382, 2008.
Article in Korean | WPRIM | ID: wpr-92315
ABSTRACT

PURPOSE:

Salvage procedures for a dysfunctional arteriovenous fistula (AVF) are defined as operation or percutaneous balloon angioplasty (PTA) for the AVF is inadequate for performing hemodialysis. This retrospective study was performed in order to identify the appropriate salvage treatment modality.

METHODS:

From April 2001 to October 2007, 132 salvage procedures in 100 patients were performed. We analyzed the overall cumulative patency rates of both the procedures and we compared them according to the type of primary AVF and the site and distribution of the stenoses.

RESULTS:

Fifty eight patients underwent operation, and 74 patients underwent PTA. The initial success rate was 77.59% for operation and 83.78% for PTA. The one year cumulative patency rates of operation and PTA were 46.11% and 21.62%, respectively (P=0.00). For the patients whose AVF had been created using autogenous vein, the one year cumulative patency rates of operation and PTA were 49.72% and 21.15%, respectively (P=0.04). According to the location and distribution of the stenoses, 56 patients (64.4%) with an autogenous AVF had juxta-anastomotic lesion. Among them, 23 patients underwent operation and 33 patients underwent PTA. The 1 year cumulative patency rates for these patients were 66.63% and 12.12%, respectively (P=0.00). For the treatment of the diffuse and multiple stenoses of the autogenous vein, PTA (n=14) showed a better patency rate than that of operation (P=0.00).

CONCLUSION:

Salvage therapy for a dysfunctional fistula prolonged their life span. Operation was superior to PTA for a juxta-anastomotic lesion of an autogenous AVF, but PTA had benefit over operation for the cases with diffuse and multiple stenoses.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Veins / Retrospective Studies / Arteriovenous Fistula / Renal Dialysis / Salvage Therapy / Angioplasty, Balloon / Constriction, Pathologic / Fistula Type of study: Observational study Limits: Humans Language: Korean Journal: Journal of the Korean Surgical Society Year: 2008 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Veins / Retrospective Studies / Arteriovenous Fistula / Renal Dialysis / Salvage Therapy / Angioplasty, Balloon / Constriction, Pathologic / Fistula Type of study: Observational study Limits: Humans Language: Korean Journal: Journal of the Korean Surgical Society Year: 2008 Type: Article