Percutaneous balloon angioplasty in dialysis fistula stenosis
PDF

Keywords

Dialysis fistula
Dialysis fistula stenosis
Angioplasty

How to Cite

Szczerbiński, J., Tarczyński, M., Bojakowski , K., & Andziak, P. (2023). Percutaneous balloon angioplasty in dialysis fistula stenosis. Wiedza Medyczna, 4(2), 1-5. https://doi.org/10.36553/wm.139

Abstract

The formation of stenosis in dialysis fistula disturbing blood flow is the most frequent complication and factor limiting its long-term function. Depending on the time and location stenosis lead to various clinical symptoms, triggering dialysis impairment. Due to its minimally invasive nature and high efficacy, percutaneous transluminal angioplasty is the treatment of choice for dialysis fistula stenosis in most locations. An important limitation of angioplasty is the significant risk of recurrent stenosis. Most procedures are performed by puncturing the fistula, performed either in line with the blood flow or opposite to the blood flow, depending on the location of the stenosis. Due to technical differences in dialysis fistula angioplasty – higher pressures of the insufflations used, shorter distance between the stenosis and the vascular access site – dedicated medical devices have been developed: balloon catheters on a shorter shaft, allowing higher insufflation pressures (up to 40 atmospheres). To reduce the risk of recurrent stenosis, drug coated/eluting balloons are also used during such surgeries.

https://doi.org/10.36553/wm.139
PDF

References

(1) Schmidli J, Widmer MK, Basile C, et al. Editor’s Choice e Vascular Access: 2018 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS), Eur J Vasc Endovasc Surg 2018; 55:757-818.

(2) Lok ChE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline For Vascular Access: 2019 Update, Am J Kidney Dis 2020; 75(4)(suppl 2):1-164.

(3) Han M, Kim JD, Bae JI, et al. Endovascular treatment for immature autogenous arteriovenous fistula, Elsevier 2013; 68:309-315.

(4) Yaeni K, Byung H, Bum Soon Ch, et al. Outcome of endovascular salvage of immature hemodialysis arteriovenous fistulas, The Journal of Vascular Access 2018; 20(1):397-403.

(5) Aktas A, Bozkurt A, Aktas B, Kirbas I. Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency, Turkish Society of Radiology 2015; 21(2):160-166.

(6) Rajan DK, Bunston S, Misra S, et al. Dysfunctional Autogenous Hemodialysis Fistulas: Outcomes after Angioplasty – Are There Clinical Predictors of Patency?, Vascular and Interventional Radiology 2004; 21:508-515.

(7) Zheng-Rong Z, Lan Z, Yue X, et al., Predictors of primary patency after percutaneous balloon angioplasty for stenosis of Brescia-Cimino hemodialysis arteriovenous fistula, Br J Radiol 2020; 93(1109):20190505. DOI:10.1259/bjr.20190505.

(8) Aktas A, Bozkurt A, Aktas B, Kirbas I, Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency, Diagn Interv Radiol 2015; 21(2):160-166.

(9) Yit-Sheung Y, Wen-Che Ch, Cheng-Hao L, et al., Factors affecting patency of arteriovenous fistula following first percutaneous transluminal angioplasty, Clinical and Experimental Nephrology 2021; 25:80-86.

(10) Liu Ch, Wolfers M, Awan BZ, et al., Drug-Coated Balloon Versus Plain Balloon Angioplasty for Hemodialysis Dysfunction: A Meta-Analysis of Randomized Controlled Trials, J Am Heart Assoc 2021; 10(23):e022060. DOI:10.1161/JAHA.121.022060.

(11) Pang SC, Tan RY, Choke E, et al. SIroliMus coated angioPlasty versus plain balloon angioplasty in the tREatment of dialySis acceSs dysfunctION (IMPRESSION): study protocol for a randomized controlled trial. Trials 22; 945:(2021). DOI:10.1186/s13063-021-05920-3.

(12) Elens M, Colle A, Verhelst R, Astarci P, Comparison of different inflation times on the angiographic image after balloon angioplasty in the femoropopliteal segment: a prospective randomized clinical trial, J Cardiovasc Surg (Torino) 2021; 62(4):364-368.

(13) Skowroński J, Woln R , Jastrzębski J, et al., Impact of the Balloon Inflation Time and Pattern on the Coronary Stent Expansion, Journal of Interventional Cardiology 2019; (7):1-10.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Metrics



Downloads

Download data is not yet available.