Document Detail

Access flow reduction and recurrent symptomatic cephalic arch stenosis in brachiocephalic hemodialysis arteriovenous fistulas.
MedLine Citation:
PMID:  20683832     Owner:  NLM     Status:  In-Data-Review    
Background: Recurrent cephalic arch stenosis (CAS) has been linked to high flow and has a high rate of recurrence following angioplasty. This study investigates the effectiveness of access flow reduction in decreasing rapidly recurrent symptomatic CAS. Methods: A retrospective study of patient records from February 2005 to April 2009 was conducted. Patients with brachiocephalic fistulas who had undergone two or more instances of cephalic arch angioplasty within 3 months, and thereafter underwent flow reduction via banding of the access inflow (n=33) were included. A before-and-after analysis was conducted: the rates of cephalic arch angioplasty were calculated for each patient before and after the banding procedure, and compared via a paired t-test. Results: At 3, 6, and 12 months, the cephalic arch primary lesion patency was 91%, 76%, and 57%. The cephalic arch intervention rate was reduced from 3.34 to 0.9 per access-year (t=7.74, p<.001). The average follow-up time was 14.5 months (range, 4.8-32). Conclusion: Flow reduction of a brachiocephalic arteriovenous hemodialysis fistula may effectively diminish the incidence of symptomatic CAS.
Gregg Arthur Miller; Alexander Friedman; Aleksandr Khariton; Dean C Preddie; Yevgeny Savransky
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of vascular access     Volume:  11     ISSN:  1129-7298     ISO Abbreviation:  J Vasc Access     Publication Date:    2010 Oct-Dec
Date Detail:
Created Date:  2011-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  281-7     Citation Subset:  IM    
American Access Care of Brooklyn, NY - USA.
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