| Angioplasty and bolus urokinase infusion for the restoration of function in thrombosed Brescia-Cimino dialysis fistulas. | |
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MedLine Citation:
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PMID: 10082098 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To evaluate the use of urokinase and angioplasty in treatment of thrombosed Brescia-Cimino fistulas. MATERIALS AND METHODS: From January 1994 to April 1997, 17 patients (10 women and seven men; age range, 17-78 years; mean 54 years) with complete thrombosis of their Brescia-Cimino fistulas were referred to our department for thrombolysis and angioplasty. Thrombosis of the fistula had occurred within 24 hours of attempted thrombolysis in 11 patients and between 24 and 72 hours in six patients. Urokinase was given as a bolus into the fistula, and heparin was administered into the central venous vasculature. Angioplasty was performed at the arterial inflow and the fistula itself. RESULTS: Procedural success was 82% (14 of 17 patients). Primary patency was 71% at 6 months and 64% at 12 months. Primary assisted patency was 93% at 6 and 12 months. Secondary patency was 100% at 6 and 12 months. One fistula thrombosed within 24 hours of the initial procedure, and a repeat procedure was successfully performed. All other fistulas have remained patent with a maximum follow-up of 40 months (average function of 16 months). Two patients have died of unrelated causes. One Wallstent was deployed for treatment of an angioplasty-induced venous rupture. CONCLUSION: Long-term function of Brescia-Cimino fistulas after thrombolysis and angioplasty is excellent with patency rates similar to those of newly placed, mature Brescia-Cimino fistulas. |
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Authors:
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G X Zaleski; B Funaki; S Kenney; J M Lorenz; R Garofalo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 10 ISSN: 1051-0443 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 1999 Feb |
Date Detail:
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Created Date: 1999-04-05 Completed Date: 1999-04-05 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 129-36 Citation Subset: IM |
Affiliation:
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Racine Radiologist Group, Wisconsin, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Angioplasty, Balloon* / adverse effects, methods Anticoagulants / administration & dosage, therapeutic use Arteriovenous Shunt, Surgical / adverse effects, instrumentation* Cause of Death Female Follow-Up Studies Graft Occlusion, Vascular / drug therapy, therapy* Heparin / administration & dosage, therapeutic use Humans Injections, Intravenous Male Middle Aged Plasminogen Activators / administration & dosage, therapeutic use* Renal Dialysis / instrumentation* Retreatment Rupture Stents Thrombolytic Therapy Thrombosis / drug therapy, therapy* Time Factors Treatment Outcome Urokinase-Type Plasminogen Activator / administration & dosage, therapeutic use* Vascular Patency Veins / injuries |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 9005-49-6/Heparin; EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
| Comments/Corrections | |
Comment In:
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J Vasc Interv Radiol. 2000 Jan;11(1):135-7
[PMID:
10693725
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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