Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Abstract

PURPOSEWe aimed to evaluate the safety and effectiveness of percutaneous transluminal angioplasty (PTA) for dysfunctional femoral arteriovenous graft and analyze clinical or anatomic predictors of graft patency.METHODSThe records of 45 patients who underwent PTA or thromboaspiration for dysfunctional or thrombosed femoral arteriovenous graft from 2005 to 2012 were reviewed retrospectively. Primary and secondary patency rates were determined at three, six, and 12 months after PTA. The primary patency rate was analyzed according to the presence of diabetes mellitus, graft age from the time of creation to the first intervention (<12 months or ≥12 months), presence of thrombus, shape of graft (U-shape vs. straight-shape), anastomosis type of graft (femoral-femoral vs. femoral-saphenous), location of stenosis (central vs. peripheral), length of stenosis (<2 cm vs. ≥2 cm), degree of stenosis severity (<70% vs. ≥70%), and stent insertion.RESULTSA total of 124 PTAs were performed in 45 patients. The primary patency rate at three, six, and 12 months was 84.8%, 63.6%, and 24.2%, respectively. The secondary patency rate at three, six, and 12 months was 95.2%, 95.2%, and 85.7%, respectively. The mean duration of primary and secondary patency was 13.2 and 35.7 months, respectively. No significant clinical or anatomical predictors of primary patency could be identified. Stent placement had a negative effect on primary patency.CONCLUSIONPTA is a safe and effective treatment for dysfunctional femoral arteriovenous grafts. Stent placement seems to improve technical success, but does not enhance the primary patency rate of dysfunctional femoral arteriovenous grafts.