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Arterial Stenosis Affecting Arteriovenous Fistulae and Grafts in Hemodialysis Patients: Approach to Diagnosis and Management

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Interventional Nephrology

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Abstract

Arterial stenoses are an underappreciated significant contributor to arteriovenous access dysfunction. Patients with end-stage renal disease have a high incidence of peripheral artery disease, and the arteries utilized for AV access creation are subject to similar pathologic processes as those of the lower extremities in this population. Adequate arterial inflow is an essential requirement of a successfully functioning arteriovenous access for hemodialysis. This chapter will provide an overview of the approach to the patient with suspected arterial stenosis leading to arteriovenous access dysfunction.

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References

  1. Long B, Brichart N, Lermusiaux P, Turmel-Rodrigues L, Artru B, Boutin JM, Pengloan J, Bertrand P, Bruyère F. Management of perianastomotic stenosis of direct wrist autogenous radial-cephalic arteriovenous accesses for dialysis. J Vasc Surg. 2011;53(1):108–14. Epub 2010 Sep 22.

    Article  PubMed  Google Scholar 

  2. Kumakura H, Kanai H, Aizaki M, Mitsui K, Araki Y, Kasama S, Iwasaki T, Ichikawa S. The influence of the obesity paradox and chronic kidney disease on long-term survival in a Japanese cohort with peripheral arterial disease. J Vasc Surg. 2010;52(1):110–7. Epub 2010 May 15.

    Article  PubMed  Google Scholar 

  3. Bonforte G, Rossi E, Auricchio S, Pogliani D, Mangano S, Mandolfo S, Galli F, Genovesi S. The middle-arm fistula as a valuable surgical approach in patients with end-stage renal disease. J Vasc Surg. 2010;52(6):1551–6. Epub 2010 Aug 25.

    Article  PubMed  Google Scholar 

  4. Schild AF, Perez E, Gillaspie E, Seaver C, Livingstone J, Thibonnier A. Arteriovenous fistulae vs. arteriovenous grafts: a retrospective review of 1,700 consecutive vascular access cases. J Vasc Access. 2008;9(4):231–5.

    PubMed  CAS  Google Scholar 

  5. Hong HP, Kim SK. Usefulness of percutaneous intervention with transarterial approach in the salvage of nonmaturing native fistulas status-post transvenous approach failure: transarterial approach in the salvage of nonmaturing native fistulas. Cardiovasc Intervent Radiol. 2009;32(6):1252–6. Epub 2009 Jul 31.

    Article  PubMed  Google Scholar 

  6. Escobar C, Blanes I, Ruiz A, Vinuesa D, Montero M, Rodríguez M, Barbera G, Manzano L. Prevalence and clinical profile and management of peripheral arterial disease in elderly patients with diabetes. Eur J Intern Med. 2011;22(3):275–81. Epub 2011 Mar 15.

    Article  PubMed  Google Scholar 

  7. Asif A, Gadalean FN, Merrill D, et al. Inflow stenosis in arteriovenous fistulas and grafts: a multicenter, prospective study. Kidney Int. 2005;67:1986–92.

    Article  PubMed  Google Scholar 

  8. Rattanasompattikul M, Chanchairujira K, On-Ajyooth L, Chanchairujira T. Evaluation of atherosclerosis, arterial stiffness and related risk factors in chronic hemodialysis patients in Siriraj Hospital. J Med Assoc Thai. 2011;94 Suppl 1:S117–24.

    PubMed  Google Scholar 

  9. Puntmann VO, Bigalke B, Nagel E. Characterization of the inflammatory phenotype in atherosclerosis may contribute to the development of new therapeutic and preventative interventions. Trends Cardiovasc Med. 2010;20(5):176–81.

    Article  PubMed  CAS  Google Scholar 

  10. Swaminathan S, Shah SV. Novel inflammatory mechanisms of accelerated atherosclerosis in kidney disease. Kidney Int. 2011;80:453–63.

    Article  PubMed  CAS  Google Scholar 

  11. Tessitore N, Bedogna V, Melilli E, Millardi D, Mansueto G, Lipari G, Mantovani W, Baggio E, Poli A, Lupo A. In search of an optimal bedside screening program for arteriovenous fistula stenosis. Clin J Am Soc Nephrol. 2011;6:819–26.

    Article  PubMed  Google Scholar 

  12. Grogan J, Castilla M, Lozanski L, Griffin A, Loth F, Bassiouny H. Frequency of critical stenosis in primary arteriovenous fistulae before hemodialysis access: should duplex ultrasound surveillance be the standard of care? J Vasc Surg. 2005;41:1000–6.

    Article  PubMed  Google Scholar 

  13. Marin D, Nelson RC, Schindera ST, Richard S, Youngblood RS, Yoshizumi TT, Samei E. Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm–initial clinical experience. Radiology. 2010;254(1):145–53.

    Article  PubMed  Google Scholar 

  14. Coelman C, Duijm LEM, Liem YS, et al. Stenosis detection in failing hemodialysis access fistulas and grafts: comparison of color Doppler ultrasonography, contrast-enhance magnetic resonance angiography and digital subtraction angiography. J Vasc Surg. 2005;42:739–46.

    Article  Google Scholar 

  15. Khan FA, Vesely TM. Arterial problems associated with dysfunctional hemodialysis grafts: evaluation of patients at high risk for arterial disease. J Vasc Interv Radiol. 2002;13(1109–1114):12.

    Google Scholar 

  16. Kanterman RY, Vesely TM, Pilgram TK, et al. Dialysis access grafts: anatomic location of venous stenosis and results of angioplasty. Radiology. 1995;195:135–9.

    PubMed  CAS  Google Scholar 

  17. Duijm LE, Liem YS, van der Rijt RH, Nobrega FJ, van den Bosch HC, Douwes-Draaijer P, Cuypers PW, Tielbeek AV. Inflow stenosis in dysfunctional hemodialysis access fistulae and grafts. Am J Kidney Dis. 2006;48(1):98–105.

    Article  PubMed  Google Scholar 

  18. Duijm LEM, van der Rijt RHH, Cuypers PWM, et al. Outpatient treatment of arterial inflow stenoses of dysfunctional hemodialysis access fistulas by retrograde venous access puncture and catheterization. J Vasc Surg. 2008;47:591–8.

    Article  PubMed  Google Scholar 

  19. Guerra A, Raynaud A, Beyssen B, et al. Arterial percutaneous angioplasty in upper limbs with vascular access device for haemodialysis. Nephrol Dial Transplant. 2002;17:843–51.

    Article  PubMed  Google Scholar 

  20. Yevzlin AS, Asif A. Arterial stenoses in patients with arteriovenous dialysis access. US Nephrology 2.

    Google Scholar 

  21. Duijm LE, Overbosch EH, Liem YS, et al. Retrograde catheterization of haemodialysis fistulae and grafts: angiographic depiction of the entire vascular access tree and stenosis treatment. Nephrol Dial Transplant. 2009;24:539–47.

    Article  PubMed  Google Scholar 

  22. Shemesh D, Goldin I, Zaghal I, Berlowitz D, Raveh D, Olsha O. Angioplasty with stent graft versus bare stent for recurrent cephalic arch stenosis in autogenous arteriovenous access for hemodialysis: a prospective randomized clinical trial. J Vasc Surg. 2008;48(6):1524–31, 1531.e1–2. Epub 2008 Oct 1.

    Article  PubMed  Google Scholar 

  23. Beathard GA. Angioplasty for arteriovenous grafts and fistulae. Semin Nephrol. 2002;22:202–10.

    Article  PubMed  Google Scholar 

  24. Chan MR, Chhokar VS, Young HN, et al. Retrograde occlusive arteriography of hemodialysis access: failure to detect inflow lesions? Semin Dial. 2010;24:452–5.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Vascular Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Diego A. Covarrubias MD, Chieh Suai Tan MBBS & Steven Wu MD

  2. Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Diego A. Covarrubias MD, Chieh Suai Tan MBBS & Steven Wu MD

  3. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Steven Wu MD

Authors
  1. Diego A. Covarrubias MD
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  2. Chieh Suai Tan MBBS
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  3. Steven Wu MD
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Corresponding author

Correspondence to Steven Wu MD .

Editor information

Editors and Affiliations

  1. Department of Medicine (CHS), Division of Nephrology, Madison, Wisconsin, USA

    Alexander S. Yevzlin

  2. Medicine, Nephrology and Hypertension, Albany Medical College, Albany, New York, USA

    Arif Asif

  3. Interventional Nephrology Nephrology and Hypertension, University of Miami Miller School of Med, Miami, Florida, USA

    Loay Salman

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Covarrubias, D.A., Tan, C.S., Wu, S. (2014). Arterial Stenosis Affecting Arteriovenous Fistulae and Grafts in Hemodialysis Patients: Approach to Diagnosis and Management. In: Yevzlin, A., Asif, A., Salman, L. (eds) Interventional Nephrology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8803-3_23

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  • DOI: https://doi.org/10.1007/978-1-4614-8803-3_23

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8802-6

  • Online ISBN: 978-1-4614-8803-3

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