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Endovascular Treatment of Autogenous Radiocephalic Fistulas with the “Eighth Note” Deformity for Hemodialysis

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Abstract

The purpose of this paper is to describe a unique “eighth note” deformity of the autogenous radiocephalic fistula for hemodialysis and to retrospectively evaluate the efficacy and safety of its endovascular treatment. Over 3 years, a total of 808 patients and 558 autogenous radiocephalic fistulas were treated for vascular access dysfunction or thrombosis. These included 14 fistulas in 14 patients (9 men, 5 women; mean age, 58.2 ± 2.8 years; range 27–79 years) whose fistulograms before treatment resembled a musical note, the eighth note. Endovascular treatment sought to remodel the deformed vascular access to a classic radiocephalic fistula and increase the number of cannulation sites available for hemodialysis. The technical and clinical success rates were each 92.8% (13/14). Fistula remodeling was successful in 13 patients. The postintervention primary patency was 100% at 90 days, 91.7 ± 0.8% at 120 days, 78.6 ± 13.9% at 180 days, 62.9 ± 17.9% at 360 days, 31.4 ± 24.0% at 540 days, and 0% at 720 days. The postintervention secondary patency was 100% at 90 days, 100% at 120 days, 100% at 180 days, 85.7 ± 13.2% at 360 days, and 85.7 ± 13.2% at 720 days. No major complications were noted. Minor complications were found in 71.4% of patients, all of which resolved spontaneously. In conclusion, endovascular treatment of fistulas with the eighth note deformity can effectively increase the number of available cannulation sites, facilitate fistula maturation, and facilitate thromboaspiration after fistula thrombosis.

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Acknowledgment

The authors thank Miss Yi-Wen Wu, the executive secretary of VAT, for her assistance in providing clinical follow-up for this study.

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Authors and Affiliations

  1. Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Mei-Jui Weng, Huei-Lung Liang & Huay-Ben Pan

  2. Department of Radiology, Yuan’s General Hospital, No. 162, Cheng-gong 1st Road, Lingya District, Kaohsiung, 802, Taiwan

    Matt Chiung-Yu Chen

  3. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Mei-Jui Weng, Matt Chiung-Yu Chen, Huei-Lung Liang & Huay-Ben Pan

  4. Department of Internal Medicine, Division of Nephrology, Yuan’s General Hospital, Kaohsiung, Taiwan

    Wen-Che Chi & Yi-Chun Liu

  5. Department of Nursing, Yuan’s General Hospital, Kaohsiung, Taiwan

    Ko-Fen Chien

Authors
  1. Mei-Jui Weng
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  2. Matt Chiung-Yu Chen
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  3. Wen-Che Chi
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  4. Yi-Chun Liu
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  6. Huei-Lung Liang
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  7. Huay-Ben Pan
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Correspondence to Matt Chiung-Yu Chen.

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Weng, MJ., Chen, M.CY., Chi, WC. et al. Endovascular Treatment of Autogenous Radiocephalic Fistulas with the “Eighth Note” Deformity for Hemodialysis. Cardiovasc Intervent Radiol 33, 67–73 (2010). https://doi.org/10.1007/s00270-009-9639-y

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  • DOI: https://doi.org/10.1007/s00270-009-9639-y

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