Endovascular stent-graft treatment for graft-vein anastomotic stenosis in haemodialysis patients with arteriovenous grafts

• Published in: VASA Vol. 44; no. 6; p. 466
• Main Authors: Lin, Chia-Hsun, Chen, Yen-Yang, Chua, Chai-Hock, Lu, Ming-Jen
• Format: Journal Article
• Language: English
• Published: Switzerland 01.11.2015
• Subjects: Aged; Arteriovenous Shunt, Surgical - adverse effects; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - instrumentation; Endovascular Procedures - instrumentation; Graft Occlusion, Vascular - diagnosis; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - physiopathology; Graft Occlusion, Vascular - surgery; Humans; Male; Middle Aged; Prosthesis Design; Punctures; Renal Dialysis; Reoperation; Retrospective Studies; Risk Factors; Stents; Time Factors; Treatment Outcome; Upper Extremity - blood supply; Vascular Patency; haemodialysis; arteriovenous graft; graft-vein stenosis; Stent-graft
• ISSN: 0301-1526
• DOI: 10.1024/0301-1526/a000470

In this study, we investigated the patency of endovascular stent grafts in haemodialysis patients with arteriovenous grafts, the modes of patency loss, and the risk factors for re-intervention. Haemodialysis patients with graft-vein anastomotic stenosis of their arteriovenous grafts who were treated with endovascular stent-grafts between 2008 and 2013 were entered into this retrospective study. Primary and secondary patency, modes of patency loss, and risk factors for intervention were recorded. Cumulative circuit primary patency rates decreased from 40.0% at 6 months to 7.3% at 24 months. Cumulative target lesion primary patency rates decreased from 72.1% at 6 months to 22.0% at 24 months. Cumulative secondary patency rates decreased from 81.3% at 12 months to 31.6% at 36 months. Patients with a history of cerebrovascular accident had a significantly higher risk of secondary patency loss, and graft puncture site stenosis jeopardised the results of stent-graft treatment. Our data can help to improve outcomes in haemodialysis patients treated with stent-grafts for venous anastomosis of an arteriovenous graft.