Document Detail


Salvaging and maintaining non-maturing Brescia-Cimino haemodialysis fistulae by percutaneous intervention.
MedLine Citation:
PMID:  16679113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To report our experience of the salvage of non-maturing Brescia-Cimino dialysis fistulae by percutaneous intervention. MATERIALS AND METHODS: Twenty-two patients (15 men, 68%; mean age: 58 years range: 42-79) with non-maturing Brescia-Cimino fistulae were treated by percutaneous angioplasty. Fistulae were created a mean of 2.7 months (range, 1-13 months) before intervention. The size of balloons used was 4mm for the arterial and anastomotic stenosis and 5mm or 6mm for the venous stenosis. RESULTS: On initial venography, venous stenosis (17 fistulae) or occlusions (five fistulae) were responsible for non-maturation. Stenoses or occlusions were adjacent to the arterial anastomoses in 18 patients and in the venous outflow (future puncture zone) in four patients. Additionally, a focal arterial stenosis was present in one and occlusion of the innominate vein in one other patient. Clinical success (initiation of dialysis) was achieved in 21/22 patients (95.5%). Twelve patients required 18 repeat angioplasties for recurrent stenosis. Two patients had small extravasation that required no further treatment. Over a follow-up period of 5-40 months (mean 14.6 months) 12 patients required repeat angioplasty. The mean interval between the initial angioplasty and subsequent intervention was 7.5 month (range 3-12 months). Primary patency after intervention at 6 and 12 months was 82 and 28%. Secondary patency at 6 and 12 months was 95 and 85%. CONCLUSION: Percutaneous intervention can effectively salvage non-maturing Brescia-Cimino fistulae. As repeat angioplasty is often necessary to maintain function, careful surveillance is necessary.
Authors:
H-H Song; Y-D Won; Y-O Kim; S-A Yoon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical radiology     Volume:  61     ISSN:  0009-9260     ISO Abbreviation:  Clin Radiol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-08     Completed Date:  2006-06-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1306016     Medline TA:  Clin Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  404-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Halla Hospital, Yeon-Dong, Jeju, Jeju-Do, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography / methods
Angioplasty, Balloon / methods*
Arteries / pathology
Arteriovenous Shunt, Surgical / adverse effects,  methods*
Brachiocephalic Veins / pathology,  radiography,  surgery
Constriction, Pathologic
Female
Forearm / blood supply,  pathology,  surgery
Humans
Kidney Failure, Chronic / therapy
Male
Middle Aged
Phlebography / methods
Renal Dialysis / methods*
Reoperation
Retrospective Studies
Treatment Outcome
Comments/Corrections
Comment In:
Clin Radiol. 2006 May;61(5):402-3   [PMID:  16679112 ]

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