Document Detail


Flow in hemodialysis grafts after angioplasty: Do radiologic criteria predict success?
MedLine Citation:
PMID:  11318971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The anatomic success of percutaneous angioplasty of venous stenosis is determined by the improvement in cross-sectional diameter of the vessel. A successful outcome is defined as a residual stenosis of <30%. The purpose of this study was to determine whether the angiographic assessment of a venous stenosis correlates with the change in graft blood flow following angioplasty. METHODS: Twenty-two hemodialysis patients with decreased intragraft blood flow (<700 mL/min) underwent diagnostic fistulography and angioplasty. All grafts were patent at the time of the procedure. Intragraft blood flow was measured before and after angioplasty using the ultrasonic dilution technique. Change in graft blood flow after angioplasty was correlated to the morphologic changes of the treated stenosis. RESULTS: The mean preangioplasty and postangioplasty graft blood flows were 457 +/- 136 and 818 +/- 202 mL/min, respectively. The mean degree of stenosis before angioplasty was 74 +/- 15% and 18 +/- 14% after dilation (P < 0.001). The only variable that significantly correlated with postangioplasty blood flow was preangioplasty flow (r2 = 0.22, P < 0.001). The postangioplasty blood flow was not significantly different than the highest recorded blood flow measured in that graft (798 +/- 213 mL/min, P = NS). There was no significant correlation between the change in blood flow and the change in percentage of stenosis. CONCLUSION: Following angioplasty of a venous stenosis, the graft blood flow is most closely predicted by the preprocedural blood flow and is similar to the highest recorded blood flow ever measured in that graft. Angiographic criteria to assess the success of angioplasty are not predictive of changes in blood flow.
Authors:
S N Ahya; D W Windus; T M Vesely
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  59     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-25     Completed Date:  2001-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1974-8     Citation Subset:  IM    
Affiliation:
Renal Division, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Arteriovenous Shunt, Surgical*
Blood Flow Velocity
Catheters, Indwelling
Constriction, Pathologic
Female
Humans
Male
Middle Aged
Renal Dialysis*
Retrospective Studies
Veins / pathology,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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