Result of angioplasty of Brescia-Cimino haemodialysis fistulae: Medium-term follow-up

Aim: To determine the results of transluminal angioplasty in patients with Brescia-Cimino arteriovenous fistulae. Patients and Methods: Thirty-one patients underwent transluminal angioplasty of 36 stenotic lesions related to Brescia-Cimino arteriovenous fistulae over a 5-year period. The lesions tre...

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Published in:	Clinical radiology Vol. 53; no. 8; pp. 608 - 611
Main Authors:	Lay, J.P.Y., Ashleigh, R.J., Tranconi, L., Ackrill, P., Al-Khaffaf, H.
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Ltd 01-08-1998 Elsevier Elsevier Science Ltd
Subjects:	Angioplasty, Balloon Arteriovenous Shunt, Surgical Biological and medical sciences Constriction, Pathologic - diagnostic imaging Constriction, Pathologic - therapy Follow-Up Studies Forearm - blood supply Humans Medical sciences Radiography Renal Dialysis Reoperation Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Vascular Patency Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels Human Hemodialysis Cardiovascular disease Fistula Retrospective Result Vascular disease Plasty Extrarenal dialysis Treatment Surgery Blood vessel Complication Medium term Technique
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Summary:	Aim: To determine the results of transluminal angioplasty in patients with Brescia-Cimino arteriovenous fistulae. Patients and Methods: Thirty-one patients underwent transluminal angioplasty of 36 stenotic lesions related to Brescia-Cimino arteriovenous fistulae over a 5-year period. The lesions trested were characterized by review of pre-angioplasty fistulograms. Medical and radiological records were reviewed to assess medium-term patency of each patient's fistula. Results: Angioplasty was performed successfully in 28 out of 31 patients initially (90% technical success rate). Duration of follow-up for the 31 patients ranged from 4 to 65 months (median=34 months). At 6 months, seven patients required further surgical or endovascular intervention (18 patients remained event-free) and at 1 year, 10 patients required further endovascular or surgical intervention (14 patients remained event-free). Life-table analysis revealed primary patency rates of 77%, 64% and 39% at 6 months, 1 year and 2 years, respectively. At 6 months and 1 year, four and five patients, respectively, required surgical revision or closure of fistula. Secondary patency rates were 85%, 81% and 65% at 6 months, 1 year and 2 years, respectively. All patients with a primary patency at 2 years remained event-free during the follow-up period. Conclusions: Transluminal angioplasty is an effective treatment for stenoses developed in relation to Brescia-Cimino haemodialysis fistulae. Further endovascular procedures may be required, especially in the first 24 months, to preserve patency. These techniques extend the lifetime of fistulae, thereby preserving proximal venous access sites for future use. Our result is in broad agreement with results from other series.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0009-9260 1365-229X
DOI:	10.1016/S0009-9260(98)80155-4