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Title: Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

Abstract

PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flowmore » rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.« less

Authors:
; ; ;
Publication Date:
OSTI Identifier:
22645410
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 39; Journal Issue: 10; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FAILURES; FLOW RATE; GRAFTS; HAZARDS; LOSSES; PATIENTS; TRANSONIC FLOW; VASCULAR DISEASES

Citation Formats

Sidhu, Arshdeep, Tan, Kong T., Noel-Lamy, Maxime, Simons, Martin E., and Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.ca. Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1401-7.
Sidhu, Arshdeep, Tan, Kong T., Noel-Lamy, Maxime, Simons, Martin E., & Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.ca. Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?. United States. doi:10.1007/S00270-016-1401-7.
Sidhu, Arshdeep, Tan, Kong T., Noel-Lamy, Maxime, Simons, Martin E., and Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.ca. Sat . "Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?". United States. doi:10.1007/S00270-016-1401-7.
@article{osti_22645410,
title = {Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?},
author = {Sidhu, Arshdeep and Tan, Kong T. and Noel-Lamy, Maxime and Simons, Martin E. and Rajan, Dheeraj K., E-mail: dheeraj.rajan@uhn.ca},
abstractNote = {PurposeTo study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.Materials and MethodsA prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.ResultsTechnical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.ConclusionTechnical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.},
doi = {10.1007/S00270-016-1401-7},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 10,
volume = 39,
place = {United States},
year = {2016},
month = {10}
}