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Title: Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique

Abstract

We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performed via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforationmore » in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas.« less

Authors:
 [1];  [2]; ; ; ; ; ;  [3];  [4]
  1. Fukuiken Saiseikai Hospital, Department of Diagnostic Radiology (Japan), E-mail: s-miyayama@fukui.saiseikai.or.jp
  2. Kanazawa University, Graduate School of Medical Science, Department of Radiology (Japan)
  3. Fukuiken Saiseikai Hospital, Department of Diagnostic Radiology (Japan)
  4. Fukuiken Saiseikai Hospital, Department of Internal Medicine (Japan)
Publication Date:
OSTI Identifier:
21091329
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 28; Journal Issue: 6; Other Information: DOI: 10.1007/s00270-004-0105-6; Copyright (c) 2005 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; HEMATOMAS; PATIENTS; RUPTURES; THERAPY; VASCULAR DISEASES; VEINS

Citation Formats

Miyayama, Shiro, Matsui, Osamu, Taki, Keiichi, Minami, Tetsuya, Shinmura, Rieko, Ito, Chiharu, Takamatsu, Shigeyuki, Kobayashi, Miki, and Ushiogi, Yashuyuki. Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique. United States: N. p., 2005. Web. doi:10.1007/S00270-004-0105-6.
Miyayama, Shiro, Matsui, Osamu, Taki, Keiichi, Minami, Tetsuya, Shinmura, Rieko, Ito, Chiharu, Takamatsu, Shigeyuki, Kobayashi, Miki, & Ushiogi, Yashuyuki. Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique. United States. doi:10.1007/S00270-004-0105-6.
Miyayama, Shiro, Matsui, Osamu, Taki, Keiichi, Minami, Tetsuya, Shinmura, Rieko, Ito, Chiharu, Takamatsu, Shigeyuki, Kobayashi, Miki, and Ushiogi, Yashuyuki. Thu . "Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique". United States. doi:10.1007/S00270-004-0105-6.
@article{osti_21091329,
title = {Occluded Brescia-Cimino Hemodialysis Fistulas: Endovascular Treatment with Both Brachial Arterial and Venous Access Using the Pull-Through Technique},
author = {Miyayama, Shiro and Matsui, Osamu and Taki, Keiichi and Minami, Tetsuya and Shinmura, Rieko and Ito, Chiharu and Takamatsu, Shigeyuki and Kobayashi, Miki and Ushiogi, Yashuyuki},
abstractNote = {We retrospectively evaluated the usefulness of both arterial and venous access with the pull-through technique in endovascular treatment of totally occluded Brescia-Cimino fistulas. We treated 26 patients (17 men, 9 women; age range 43-82 years, mean age 66 years) with occluded Brescia-Cimino fistulas. First, the occluded segment was traversed from the antegrade brachial arterial access using a microcatheter-guidewire system. Second, the vein was retrogradely punctured after confirmation of all diseased segments, and a 0.014- or 0.016-inch guidewire was pulled through the venous access when the occluded segment was long. All interventions including thrombolysis, thromboaspiration, angioplasty, and stent placement were performed via the venous access. The occlusion was successfully crossed via the brachial arterial access in 23 patients (88%). In 2 patients it was done from the venous approach. In the remaining patient it was not possible to traverse the occluded segment. The pull-through technique was successful in all 19 attempts. Clinical success was achieved in 96%, the primary patency rates at 6, 12, and 18 months were 83%, 78%, and 69%, the primary assisted patency rates were 92%, 92%, and 72%, and the secondary patency rates were 92%, 92%, and 92%, respectively. Minor complications in 5 patients included venous perforation in 2 (8%), venous rupture in 1 (4%), and regional hematoma in 2 (8%). Our study suggests that endovascular treatments with both arterial and venous access using the pull-through technique are highly effective in restoring function in totally occluded Brescia-Cimino fistulas.},
doi = {10.1007/S00270-004-0105-6},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 28,
place = {United States},
year = {Thu Dec 15 00:00:00 EST 2005},
month = {Thu Dec 15 00:00:00 EST 2005}
}