Document Detail


Wallstents and Craggstents in hemodialysis grafts and fistulas: results for selective indications.
MedLine Citation:
PMID:  9399466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the value of selective placement of self-expandable stents (Wallstent and Craggstent) for the treatment of limitations and, occasionally, of complications of dilation in hemodialysis access, and especially for delaying restenosis. MATERIALS AND METHODS: This is a retrospective study of a 7-year period, during which 41 Wallstents and 11 Craggstents were placed in 26 polytetrafluoroethylene (PTFE) grafts, 15 native fistulas, and nine central veins of 47 patients. The indications were stenosis recoil (n = 13), recurrent restenosis within 6 months (n = 33), restenosis after 6 months (n = 3), and acute angioplasty-induced rupture (n = 1). Restenosis after stent placement necessitated redilation and percutaneous declotting and 10 additional stent placements. RESULTS: Two initial misplacements were corrected immediately. Primary patency rates for PTFE grafts were 58% +/- 10% at 6 months and 23% +/- 10% at 1 year, respectively. Secondary patency rates were 100% at 6 months and 88% +/- 8% at 1 year, respectively. For native fistulas, primary patency rates were 47% +/- 12% at 6 months and 20% +/- 18% at 1 year. Secondary patency rates were 95% +/- 6% at 6 months and 79% +/- 14% at 1 year. It was necessary to reintervene after stent placement to maintain or to restore patency every 9 months for PTFE grafts and every 7.3 months for native fistulas. When stents were placed for treatment of early recurring restenosis, the mean interval between radiologic interventions (redilations or declottings) performed to maintain or to restore patency before stent placement was multiplied by 2.1 after stent placement for both grafts (3.2 months increased to 6.9, P < .01) and native fistulas (2.9 months increased to 6.2, P < .02). CONCLUSIONS: Wallstents and Craggstents are valuable for the treatment of failure of regular dilation and they double the intervals between reinterventions for early (< 6 months) recurring stenoses in PTFE grafts and native fistulas.
Authors:
L A Turmel-Rodrigues; D Blanchard; J Pengloan; M Sapoval; S Baudin; D Testou; A Mouton; M Abaza
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  8     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-01-22     Completed Date:  1998-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  975-82     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Radiology, Clinique St-Gatien, Tours, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical / adverse effects
Arteriovenous Fistula / etiology,  therapy*
Arteriovenous Shunt, Surgical / adverse effects*
Female
Graft Occlusion, Vascular / radiography,  therapy*
Humans
Male
Middle Aged
Polytetrafluoroethylene
Renal Dialysis / adverse effects*,  instrumentation
Retrospective Studies
Stents*
Vascular Patency
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

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


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