Outcomes of Interventions Via a Transradial Approach for Dysfunctional Brescia-Cimino Fistulas

Journal Article · Tue Sep 15 00:00:00 EDT 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9625-4· OSTI ID:21429098

Shyhming, Chen; Chiling, Hang; Honkan, Yip; Chiyuan, Fang; Chiungjen, Wu; Chenghsu, Yang; Yuankai, Hsieh

The transradial artery approach to angioplasty has rarely been reported as a method for treating dysfunctional Brescia-Cimino fistulas. This study evaluated the feasibility, safety, and 1-year efficacy of this method for treating dysfunctional Brescia-Cimino fistulas. We retrospectively evaluated 154 consecutive procedures in 131 patients (age, 58.3 {+-} 11.6 years; male, 48.1%) who underwent the transradial approach in dysfunctional Brescia-Cimino fistulas in the 1-year period after the procedure. The operator determined the use of a regular or a cutting balloon (two cases) in combination with urokinase injection (one case) or catheter thromboaspiration. Radial artery puncture was successful in all cases. Fifty-two cases (33.8%) had totally occluded fibrotic lesions. The overall anatomic success rate and clinical success rate were 61% (94/154) and 81.1% (125/154), respectively. In cases with a totally occluded fibrotic lesion, the clinical success rate was 46%. Successful intervention was associated with a significant reduction in the radial arterial systolic and diastolic pressures. There were no complications of symptomatic arterial embolization or pulmonary embolism, and one complication of venous rupture was successfully treated by compression. The primary patency rates based on intention-to-treat were 75.3% at 30 days and 39.0% at 1 year after the procedure. Excluding the cases with a totally occluded lesion, the clinical success rate was 99% (101/102) and the primary patency rates were 84.3% (86/102) and 52.0% (53/102) at 3 months and 1 year after the procedure, respectively. In conclusion, the transradial approach is a feasible, safe, and effective alternative for catheter intervention for dysfunctional Brescia-Cimino fistulas. Its success rate in cases with a totally occluded fibrotic lesion is unsatisfactory.

• OSTI ID: 21429098
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 32, Issue 5; Other Information: DOI: 10.1007/s00270-009-9625-4; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
FISTULAE
INJECTION
TUBES
UROKINASE
BLOOD COAGULATION FACTORS
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
DRUGS
ENZYMES
FIBRINOLYTIC AGENTS
HEMATOLOGIC AGENTS
HYDROLASES
INTAKE
NONSPECIFIC PEPTIDASES
ORGANIC COMPOUNDS
ORGANS
PATHOLOGICAL CHANGES
PEPTIDE HYDROLASES
PROTEINS