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Percutaneous Transluminal Angioplasty for Radial-Cephalic Fistulae With Stenosis at the Arteriovenous Junction.
MedLine Citation:
PMID:  22052413     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION:: The aim of this study was to analyze the predictive factors for initial success and long-term patency of percutaneous transluminal angioplasty for radial-cephalic (RC) fistulae with stenosis at the arteriovenous junction (AVJ). Stenosis at the AVJ of RC fistulae involves both the feeding artery and drainage vein and is similar to a bifurcation lesion, which carries a worse outcome. The optimal intervention method for this type of lesion is currently unknown. METHODS:: Ninety-one percutaneous transluminal angioplasty procedures for stenosis at the AVJ of RC fistulae were reviewed retrospectively. Parameters including age, sex, location of the RC fistula (right or left arm), approach site (radial artery or cephalic vein) and involvement of proximal radial artery (PRA) dilatation were analyzed for initial procedure success and long-term patency rates. RESULTS:: The total initial success rate was 94.5%. The existence of total occlusion was recognized as the only factor significantly associated with a high procedural failure rate (39% versus 0%, P < 0.001). For long-term patency rate, the only significant factor was the involvement of PRA dilatation (P = 0.026 by Cox-Mantel and 0.03 by generalized Wilcoxon methods). The 6-month, 1-year and 18-month patency rates were 64%, 45.3% and 20.9%, respectively, for all procedures, and 70.7% versus 57.8%, 56.1% versus 35.6% and 36.6% versus 6.7% for procedures with and without PRA dilatation, respectively. CONCLUSIONS:: In treating stenosis at the AVJ of RC fistulae, while initial procedural failure occurred mainly in occluded lesions, involvement of PRA dilatation was the only significant predictive factor associated with long-term patency.
Authors:
Teng-Yao Yang; Hui-Wen Cheng; Hus-Huei Weng; Shih-Tai Chang; Chang-Ming Chung; Yu-Shien Ko
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-2
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  -     ISSN:  1538-2990     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From Cardiovascular Department (t-yy, h-wc, s-tc, c-mc), Chang Gung Memorial Hospital, Chiayi; Graduate Institute of Clinical Medical Sciences (t-yy), College of Medicine, Chang Gung University, Chiayi; Department of Diagnostic Radiology (h-hw), Chang Gung Memorial Hospital, Chiayi; Chiayi Campus (s-tc, c-mc), Chang Gung Institute of Technology; The First Cardiovascular Division (y-sk), Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan; and College of Medicine (y-sk), Chang Gung University, Taoyuan, Taiwan.
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