Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Abstract

PURPOSEWe aimed to evaluate the safety and effectiveness of per-cutaneous transluminal angioplasty (PTA) for dysfunctional femoral arteriovenous graft and analyze clinical or anatomic predictors of graft patency.METHODSThe records of 45 patients who underwent PTA or throm-boaspiration for dysfunctional or thrombosed femoral arte-riovenous graft from 2005 to 2012 were reviewed retrospec-tively. Primary and secondary patency rates were determined at three, six, and 12 months after PTA. The primary patency rate was analyzed according to the presence of diabetes mel-litus, graft age from the time of creation to the first interven-tion (<12 months or >=12 months), presence of thrombus, shape of graft (U-shape vs. straight-shape), anastomosis type of graft (femoral-femoral vs. femoral-saphenous), location of stenosis (central vs. peripheral), length of stenosis (<2 cm vs. >=2 cm), degree of stenosis severity (<70% vs. >=70%), and stent insertion.RESULTSA total of 124 PTAs were performed in 45 patients. The pri-mary patency rate at three, six, and 12 months was 84.8%, 63.6%, and 24.2%, respectively. The secondary patency rate at three, six, and 12 months was 95.2%, 95.2%, and 85.7%, respectively. The mean duration of primary and secondary patency was 13.2 and 35.7 months, respectively. No signif-icant clinical or anatomical predictors of primary patency could be identified. Stent placement had a negative effect on primary patency.CONCLUSIONPTA is a safe and effective treatment for dysfunctional femoral arteriovenous grafts. Stent placement seems to improve tech-nical success, but does not enhance the primary patency rate of dysfunctional femoral arteriovenous grafts