Document Detail


A comparison of patch angioplasty and stenting for axillary venous stenoses of thrombosed hemodialysis grafts.
MedLine Citation:
PMID:  12075389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The efficacy of balloon angioplasty with stent placement is compared to surgical patch angioplasty for thrombosed upper arm hemodialysis grafts with stenotic lesions at the venous anastomosis. Patients with thrombosed hemodialysis grafts terminating at the axillary vein were reviewed. Thirty-eight stents were placed after thrombectomy and venous balloon angioplasty in 26 patients. Fifteen case-matched controls underwent 23 polytetrafluoroethylene patch angioplasties for similar lesions. Kaplan-Meier survival analysis was used for statistical comparison. Primary patency for stent placement compared with patch angioplasty was not statistically different at any time through 1-year follow-up (37% vs 55% at 3 months, 25% vs 45% at 6 months, and 25% vs 15% at 12 months, respectively; p = 0.37). Secondary patency rates were slightly better for patch angioplasty compared with stent placement (78% vs 59% at 3 months, 78% vs 48% at 6 months, and 54% vs 32% at 12 months, respectively) however these differences were not statistically significant (p = 0.13). There was no difference in complication rates between groups. Sustained patency is poor for both angioplasty with stent placement and surgical patch angioplasty when revising thrombosed dialysis grafts with anastomotic axillary vein stenosis. These data suggest slightly better patency for the routine use of patch angioplasty for these lesions. However, the endovascular approach appears to be a reasonable alternative when surgical exposure is difficult.
Authors:
Joseph V Lombardi; Matthew J Dougherty; Nestor Veitia; Jack Somal; Keith D Calligaro
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  36     ISSN:  1538-5744     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:    2002 May-Jun
Date Detail:
Created Date:  2002-06-20     Completed Date:  2002-07-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-9     Citation Subset:  IM    
Affiliation:
Section on Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA. Doclom@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty
Arteriovenous Shunt, Surgical*
Axilla
Case-Control Studies
Female
Humans
Life Tables
Male
Polytetrafluoroethylene
Stents*
Treatment Outcome
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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