Skip to main content
SpringerLink
Log in

Use of the Amplatzer Type 2 Plug for Flow Redirection in Failing Autogenous Hemodialysis Fistulae

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To present our experience with redirecting the outflow of mature arteriovenous fistulae (AVFs) in patients with cannulation and/or suboptimal flow problems by percutaneous intervention using the Amplatzer Vascular Plug II (AVP II).

Methods

We retrospectively reviewed patients who presented with difficulty in cannulation and/or suboptimal flow in the puncture zone of the AVF and who underwent intervention using the AVP II to redirect the outflow through a better cannulation zone from March 2009 to November 2012. The mean survival rate of all AVFs was estimated, and the effects of patient age, sex, and AVF age on the AVF survival time were determined.

Results

In total, 31 patients (17 male and 14 female) with a mean age of 57.8 years (range, 20–79 years) were included. In 2 patients, the AVF failed within the first 15 days because of rapid thrombosis. In 9 patients, the new AVF route was working effectively until unsalvageable thrombosis developed. One of the 31 patients died 9 months before the last radiologic evaluation. The new AVF route was still being used for dialysis in the remaining 19 patients. The mean AVF survival rate was 1,061.4 ± 139.4 days (range, 788–1,334 days). Patient age, sex, and AVF age did not affect the survival time.

Conclusion

We suggest that the AVP II is useful for redirecting the outflow of AVFs with cannulation problems and suboptimal flow. Patency of existing AVFs may be extended, thereby extending surgery-free or catheter intervention-free survival period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Hijazi ZM (2004) New device for percutaneous closure of aortopulmonary collaterals. Catheter Cardiovasc Interv 63(4):482–485

    Article  PubMed  Google Scholar 

  2. Gumus B (2011) Percutaneous embolization of hemodialysis fistulas by AMPLATZER vascular plug with midterm follow-up. J Vasc Interv Radiol 22(11):1581–1585

    Article  PubMed  Google Scholar 

  3. Ozyer U, Aytekin C, Yildirim UM, Harman A, Karakayali F, Boyvat F (2011) Use of the Amplatzer(R) Vascular Plug II in endovascular occlusion of dialysis shunts with tributary veins. J Vasc Access 12(1):76–77

    Article  PubMed  Google Scholar 

  4. Ozyer U, Harman A, Aytekin C, Boyvat F, Karakayali F (2009) Application of the AMPLATZER vascular plug in endovascular occlusion of dialysis accesses. Cardiovasc Interv Radiol 32(5):967–973

    Article  Google Scholar 

  5. Bui JT, Gaba RC, Knuttinen MG, West DL, Owens CA (2009) Amplatzer vascular plug for arteriovenous hemodialysis access occlusion: initial experience. J Vasc Access 10(1):5–10

    CAS  PubMed  Google Scholar 

  6. Powell S, Narlawar R, Odetoyinbo T, Littler P, Oweis D, Sharma A et al (2010) Early experience with the Amplatzer Vascular Plug II for occlusive purposes in arteriovenous hemodialysis access. Cardiovasc Interv Radiol 33(1):150–156

    Article  Google Scholar 

  7. Jennings WC, Galt SW, Shenoy S, Lang S, Ledenheim ED, Glickman MH et al (2014) The Venous Window Needle Guide, a hemodialysis cannulation device for salvage of uncannulatable arteriovenous fistulas. J Vasc Surg 60(4):1024–1032 Epub 2014 May 13

    Article  PubMed  Google Scholar 

  8. Tordoir JH, van Loon MM, Peppelenbosch N, Bode AS, Poeze M, van der Sande FM (2010) Surgical techniques to improve cannulation of hemodialysis vascular access. Eur J Vasc Endovasc Surg 39(3):333–339

    Article  CAS  PubMed  Google Scholar 

  9. Owens CA, Bui JT, West DL, Sepahdari A (2007) Use of the Amplatzer Vascular Plug as a coil constrainer during endovascular occlusion of a dialysis shunt. Cardiovasc Interv Radiol 30(4):754–756

    Article  Google Scholar 

  10. Yan Y, Soulen MC, Shlansky-Goldberg RD, Stavropoulos SW, Dagli M, Itkin M et al (2012) Evaluation of immature hemodialysis arteriovenous fistulas based on 3-French retrograde micropuncture of brachial artery. Am J Roentgenol 199(3):683–690

    Article  Google Scholar 

  11. Beathard GA, Arnold P, Jackson J, Litchfield T (2003) Aggressive treatment of early fistula failure. Kidney Int 64(4):1487–1494

    Article  PubMed  Google Scholar 

  12. Taghizadeh A, Dasgupta P, Khan MS, Taylor J, Koffman G (2003) Long-term outcomes of brachiobasilic transposition fistula for haemodialysis. Eur J Vasc Endovasc Surg 26(6):670–672

    Article  CAS  PubMed  Google Scholar 

  13. Faiyaz R, Abreo K, Zaman F, Pervez A, Zibari G, Work J (2002) Salvage of poorly developed arteriovenous fistulae with percutaneous ligation of accessory veins. Am J Kidney Dis 39(4):824–827

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Alper Bozkurt, Ismail Kırbaş, Benan Kasapoğlu and Mehmet Akif Teber declares that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required.

Author information

Authors and Affiliations

  1. Radiology Department, Turgut Ozal University Hospital, Ankara, Turkey

    Alper Bozkurt & İsmail Kırbaş

  2. Internal Medicine Department, Turgut Ozal University Hospital, Ankara, Turkey

    Benan Kasapoglu

  3. Radiology Department, Ataturk Education and Training Hospital, Ankara, Turkey

    Mehmet Akif Teber

  4. Turgut Özal Üniversitesi Hastanesi, Alparslan Türkeş cad. No:57 Beştepe Yenimahalle, Ankara, Turkey

    Alper Bozkurt

Authors
  1. Alper Bozkurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. İsmail Kırbaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benan Kasapoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehmet Akif Teber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alper Bozkurt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bozkurt, A., Kırbaş, İ., Kasapoglu, B. et al. Use of the Amplatzer Type 2 Plug for Flow Redirection in Failing Autogenous Hemodialysis Fistulae. Cardiovasc Intervent Radiol 38, 887–893 (2015). https://doi.org/10.1007/s00270-014-1030-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-014-1030-y

Keywords

Search

Navigation