Intraoperative Balloon Angioplasty Using Fogarty Artertial Embolectomy Balloon Catheter for Creation of Arteriovenous Fistula for Hemodialysis: Single Center Experience

Abstract

Background: The purpose of this study was to evaluate the use of a Fogarty arterial embolectomy catheter (Fogarty catheter) in intraoperative balloon angioplasty of the cephalic vein, in order to determine its effect on the patency of arteriovenous fistulas (AVFs) created for hemodialysis access. Methods: A total of 156 patients who underwent creation of an AVF were divided into two groups, based whether a Fogarty catheter was used during AVF creation. Group A (89 patients) comprised the patients who underwent balloon angioplasty with a Fogarty catheter during the operation. Group B (67 patients) included the patients in whom a Fogarty catheter was not used during the operation. Patient records were reviewed retrospectively and documented. The patency rate was determined by the Kaplan-Meier method. Results: The records of 156 patients who underwent the creation of an AVF from January 2007 to October 2011 were included. The mean follow-up duration was 40.2±19.4 months (range, 1 to 97 months). The patency rates in group A at 12, 36, and 72 months were 83.9%±3.9%, 78.3%±4.6%, and 76.3%±4.9%, respectively, while the corresponding patency rates in group B were 92.5%±3.2%, 82.8%±0.5%, and 79.9%±5.7%, respectively. The patency rates in group B were found to be slightly higher than those in group A, but the difference was not statistically significant (p=0.356). Conclusion: Intraoperative balloon angioplasty of the cephalic vein using the Fogarty catheter is a simple and easily reproducible procedure, and it can be helpful in increasing AVF patency in cases of insufficient runoff or a suboptimal cephalic vein.

Keywords

• Arteriovenous fistula
• Balloon angioplasty
• Renal dialysis
• Vascular patency
• Geriatric