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Title: The Role of Postintervention Pullback Pressure Gradient in Percutaneous Transluminal Angioplasty for Central Vein Stenosis in Dialysis Patients

Purpose: The severity of residual stenosis (RS) sometimes cannot be accurately measured by angiography during central vein intervention. This study evaluated the role of pullback pressure measurement during central vein stenosis (CVS) intervention. Methods: A retrospective review enrolled 94 consecutive dialysis patients who underwent CVS interventions but not stenting procedures. Patients were classified into 2 groups by either angiography or pressure gradient (PG) criteria, respectively. Groups divided by angiographic result were successful group (RS {<=}30 %) and acceptable group (50 % {>=} RS > 30 %), while groups divided by PG were low PG group (PG {<=}5 mmHg) and high PG group (PG >5 mmHg). Baseline characteristics and 12-month patency rates between the groups were analyzed. Results: The angiography results placed 63 patients in the successful group and 31 patients in the acceptable group. The patency rate at 12 month was not statistically different (P = 0.167). When the patients were reclassified by the postintervention pullback PG, the patency rate at 12 months was significant (P = 0.048). Further analysis in groups redivided by different combinations of RS and PG criteria identified significant differences in the group with both RS {<=}30 % and PG {<=}5 mmHg compared with those withmore » either RS >30 % (P = 0.047) or PG >5 mmHg (P = 0.027). In addition, there was a significant difference between those with both RS {<=}30 % and PG {<=}5 mmHg compared with those with both RS >30 % and PG >5 mmHg (P = 0.027). Conclusion: Postintervention PG can better predict long-term outcomes after angioplasty for CVS in nonstented dialysis patients than angiography.« less
Authors:
 [1] ;  [2] ;  [3] ; ;  [2] ; ;  [1] ; ;  [2]
  1. Chang Gung Memorial Hospital, Chiayi, Chang Gung Institute of Technology, Division of Cardiology (China)
  2. Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Division of Cardiology and Department of Internal Medicine (China)
  3. National Defense Medical Center and University, Section of Health Informatics, Institute of Public Health (China)
Publication Date:
OSTI Identifier:
22208017
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 36; Journal Issue: 5; Other Information: Copyright (c) 2013 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)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; DIALYSIS; PATIENTS; PRESSURE GRADIENTS; PRESSURE MEASUREMENT; VASCULAR DISEASES; VEINS