| Low-Flow Polytetrafluoroethylene Accesses: Ultrasound Surveillance and Preemptive Interventions Ensure Long-Term Patency. | |
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MedLine Citation:
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PMID: 20571280 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Vascular accesses (especially polytetrafluoroethylene grafts) with a permanently low flow (Qa <600 ml/min) are prone to thrombosis and thus have short patency. The reason for a permanently low flow is usually medial calcinosis of the inflow artery in diabetics. We retrospectively studied the long-term patency of low-flow grafts with careful ultrasound surveillance and preemptive interventions. Methods: Twenty subjects with Qa permanently <600 ml/min were included. Ultrasound surveillance was performed every 3 months in addition to classical monitoring techniques. Significant stenosis was strictly defined as the combination of B-mode narrowing >50% + >2-fold peak systolic velocity increase + 1 additional criterion (residual diameter <2.0 mm or flow volume decrease by >20%). Such stenoses were treated by preemptive percutaneous intervention. Primary and secondary patencies were calculated. Results: The primary patency was 357 +/- 316 days and the secondary (cumulative) patency was 996 +/- 702 days. The number of interventions was 2.09/patient year, but >10 in 6 (33%) subjects. 93 and 80% of grafts were patent 1 and 2 years after access creation, respectively. Conclusion: Low-flow accesses undergoing ultrasound surveillance with strict diagnostic criteria and preemptive interventions had patencies similar to accesses with normal Qa in our study. This was enabled by a relatively high rate of interventions. |
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Authors:
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Jan Malik; Vladimir Tuka; Eva Chytilova; Magdalena Mokrejsova; Martin Masek; Marcela Slavikova |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2010-6-23 |
Journal Detail:
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Title: Kidney & blood pressure research Volume: 33 ISSN: 1423-0143 ISO Abbreviation: - Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-7-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9610505 Medline TA: Kidney Blood Press Res Country: - |
Other Details:
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Languages: ENG Pagination: 181-185 Citation Subset: - |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Third Department of Internal Medicine, General University Hospital, Prague, Czech Republic. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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