Patency of Wallstents placed across the venous anastomosis of hemodialysis grafts after percutaneous recanalization

• Published in: Radiology Vol. 209; no. 2; p. 365
• Main Authors: Patel, R I, Peck, S H, Cooper, S G, Epstein, D M, Sofocleous, C T, Schur, I, Falk, A
• Format: Journal Article
• Language: English
• Published: United States 01-11-1998
• Subjects: Aged; Anastomosis, Surgical; Angioplasty, Balloon; Blood Vessel Prosthesis; Female; Fibrinolytic Agents - administration & dosage; Follow-Up Studies; Graft Occlusion, Vascular - therapy; Heparin - administration & dosage; Humans; Male; Polytetrafluoroethylene; Renal Dialysis; Stents; Thrombolytic Therapy; Time Factors; Urokinase-Type Plasminogen Activator - administration & dosage; Vascular Patency
• ISSN: 0033-8419
• DOI: 10.1148/radiology.209.2.9807560

To determine the patency of Wallstents placed across the venous anastomosis of prosthetic bridge grafts after percutaneous graft recanalization.
Wallstents were placed across 26 lesions at the venous anastomosis of polytetrafluoroethylene (PTFE) grafts in 25 patients (11 men, 14 women; age range, 29-83 years; mean age, 65.4 years) after pulse-spray pharmacomechanical thrombolysis. Indications for stent deployment included acute angioplasty failure, rapid restenosis, and vessel perforation.
The initial success rate was 100%. The mean primary graft patency rates (+/- standard error) at 3 and 6 months were 34% +/- 9 and 27% +/- 9, respectively. Secondary patency rates were 77% +/- 8 at 3 months, 72% +/- 9 at 6 months, and 50% +/- 10 at 12 months. Eight of the 26 grafts continued to be used for hemodialysis at the end of follow-up.
After angioplasty failure or vessel perforation, Wallstent placement at the venous anastomosis of recanalized PTFE grafts can salvage hemodialysis access function. The results of this study indicate that the 1-year secondary patency rate of these grafts is 50%, which approaches the reported rates of patency after balloon dilation as part of percutaneous graft recanalization.