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CardioVascular and Interventional Radiology

, Volume 42, Issue 1, pp 34–40 | Cite as

Factors Associated with Secondary Functional Patency After Percutaneous Transluminal Angioplasty of the Early Failing or Immature Hemodialysis Arteriovenous Fistula

  • Wataru Higashiura
  • Hiroaki Takara
  • Ryoichi Kitamura
  • Tadashi Yasutani
  • Hitoshi Miyasato
  • Toshiho Tengan
Clinical Investigation Venous Interventions
  • 96 Downloads
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To evaluate the efficacy of percutaneous transluminal angioplasty for early failing hemodialysis arteriovenous fistulas (AVFs) and predictors of secondary functional patency (FP).

Methods

A review of our endovascular registry database showed that 61 patients with early failure after a surgically created AVF underwent endovascular intervention between 2011 and 2016. Median time from AVF creation to first intervention was 5.6 weeks. Median duration of follow-up was 14 months. Items related to the technical success rate and primary and secondary FP, and factors associated with secondary FP were analyzed.

Results

Technical success was achieved in 55 (90%) of 61 patients. The primary and secondary FP rates were 42% and 65% at 12 months, respectively. Multivariate analysis showed that lesion length (HR; 1.15, P = 0.001) and lesions including juxta-AVF (the portion of fistula vein within 2 cm of the arteriovenous anastomosis, HR; 6.23, P = 0.008) were factors associated with reduced secondary FP. ROC curve analysis indicated lesion length with cutoff value ≥ 9 cm as a risk factor for reduced secondary FP. Secondary FP at 12 months for patients with no risk factors, with 1, and with 2 was 86%, 65%, and 0%, respectively. There was a significant difference in secondary FP rates among these groups (P = 0.001).

Conclusions

A lesion length and juxta-AVF lesion are the risk factors for reduced secondary FP. The secondary FP rate at 12 months is acceptable in patients without risk factors.

Keywords

Percutaneous transluminal angioplasty Hemodialysis arteriovenous fistula Early failing hemodialysis shunt Functional patency Predictive factor 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This study has obtained IRB approval from (indicate the relevant board), and the need for informed consent was waived.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Department of RadiologyOkinawa Prefectural Chubu HospitalUrumaJapan
  2. 2.Department of NephrologyOkinawa Prefectural Chubu HospitalUrumaJapan
  3. 3.Department of Cardiovascular SurgeryOkinawa Prefectural Chubu HospitalUrumaJapan

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