Document Detail


Outcomes of interventions via a transradial approach for dysfunctional Brescia-Cimino fistulas.
MedLine Citation:
PMID:  19533227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The transradial artery approach to angioplasty has rarely been reported as a method for treating dysfunctional Brescia-Cimino fistulas. This study evaluated the feasibility, safety, and 1-year efficacy of this method for treating dysfunctional Brescia-Cimino fistulas. We retrospectively evaluated 154 consecutive procedures in 131 patients (age, 58.3 +/- 11.6 years; male, 48.1%) who underwent the transradial approach in dysfunctional Brescia-Cimino fistulas in the 1-year period after the procedure. The operator determined the use of a regular or a cutting balloon (two cases) in combination with urokinase injection (one case) or catheter thromboaspiration. Radial artery puncture was successful in all cases. Fifty-two cases (33.8%) had totally occluded fibrotic lesions. The overall anatomic success rate and clinical success rate were 61% (94/154) and 81.1% (125/154), respectively. In cases with a totally occluded fibrotic lesion, the clinical success rate was 46%. Successful intervention was associated with a significant reduction in the radial arterial systolic and diastolic pressures. There were no complications of symptomatic arterial embolization or pulmonary embolism, and one complication of venous rupture was successfully treated by compression. The primary patency rates based on intention-to-treat were 75.3% at 30 days and 39.0% at 1 year after the procedure. Excluding the cases with a totally occluded lesion, the clinical success rate was 99% (101/102) and the primary patency rates were 84.3% (86/102) and 52.0% (53/102) at 3 months and 1 year after the procedure, respectively. In conclusion, the transradial approach is a feasible, safe, and effective alternative for catheter intervention for dysfunctional Brescia-Cimino fistulas. Its success rate in cases with a totally occluded fibrotic lesion is unsatisfactory.
Authors:
Shyh-Ming Chen; Chi-Ling Hang; Hon-Kan Yip; Chi-Yuan Fang; Chiung-Jen Wu; Cheng-Hsu Yang; Yuan-Kai Hsieh; Gary Bih-Fang Guo
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Publication Detail:
Type:  Journal Article     Date:  2009-06-16
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  32     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  952-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Chang Gung Memorial Hospital-Kaoshiung Medical Center, Chang Gung University College of Medicine, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Angiography
Angioplasty, Balloon / methods*
Arteriovenous Shunt, Surgical* / adverse effects
Contrast Media / administration & dosage
Feasibility Studies
Female
Humans
Male
Middle Aged
Radial Artery*
Radiography, Interventional
Renal Dialysis / methods*
Retrospective Studies
Treatment Outcome
Vascular Patency
Chemical
Reg. No./Substance:
0/Contrast Media

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


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