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Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

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

Abstract

Purpose

To study if <30 % residual stenosis post angioplasty (PTA) correlates with primary access circuit patency, and if any variables predict technical success.

Materials and Methods

A prospective observational study was performed between January 2009 and December 2012, wherein 76 patients underwent 154 PTA events in 56 prosthetic grafts (AVG) and 98 autogenous fistulas (AVF). Data collected included patient age, gender, lesion location and laterality, access type and location, number of prior interventions, and transonic flow rates pre- and postintervention. Impact of technical outcome on access patency was assessed. Univariate logistic regression was used to assess the impact of variables on technical success with significant factors assessed with a multiple variable model.

Results

Technical success rates of PTA in AVFs and AVGs were 79.6 and 76.7 %, respectively. Technical failures of PTA were associated with an increased risk of patency loss among circuits with AVFs (p < 0.05), but not with AVGs (p = 0.7). In AVFs, primary access patency rates between technical successes and failures at three and 6 months were 74.4 versus 61.9 % (p = 0.3) and 53.8 versus 23.8 % (p < 0.05), respectively. In AVGs, primary access patency rates between technical successes and failures at three and six months were 72.1 versus 53.9 % (p = 0.5) and 33.6 versus 38.5 % (p = 0.8), respectively. Transonic flow rates did not significantly differ among technically successful or failed outcomes at one or three months.

Conclusion

Technical failures of PTA had a significant impact on access patency among AVFs with a trend toward poorer access patency within AVGs.

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Abbreviations

CI:

Confidence interval

KDOQI:

Kidney disease outcomes quality initiative

SIR:

Society of interventional radiology

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Acknowledgments

We thank William S. Harmsen for his statistical analysis of the data.

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Authors and Affiliations

  1. Division of Vascular and Interventional Radiology, Peter Munk Cardiac Center, University Health Network, University of Toronto, 585 University Ave, NCSB 1C-553, Toronto, ON, M5G 2N2, Canada

    Arshdeep Sidhu, Kong T. Tan, Maxime Noel-Lamy, Martin E. Simons & Dheeraj K. Rajan

  2. Department of Radiology, Providence Hospital and Medical Centers, 16001 W 9 Mile Rd., Southfield, MI, 48075, USA

    Arshdeep Sidhu

Authors
  1. Arshdeep Sidhu
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  2. Kong T. Tan
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  3. Maxime Noel-Lamy
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Corresponding author

Correspondence to Dheeraj K. Rajan.

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All authors declare that they have no relevant conflicts of interest or financial disclosures.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.

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Sidhu, A., Tan, K.T., Noel-Lamy, M. et al. Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?. Cardiovasc Intervent Radiol 39, 1400–1406 (2016). https://doi.org/10.1007/s00270-016-1401-7

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  • DOI: https://doi.org/10.1007/s00270-016-1401-7

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