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Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

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Abstract

Purpose

To describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.

Materials and Methods

This is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.

Results

127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.

Conclusion

Endovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance is feasible and safe in roughly two-thirds of cases.

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Authors and Affiliations

  1. Vascular and Interventional Radiology Unit, Department of Radiology, “Reina Sofia” University Hospital, Calle Intendente Jorge Palacios 1, 30003, Murcia, Spain

    J. García-Medina

  2. Faculty of Medicine, University of Murcia, Espinardo, Murcia, Spain

    J. J. García-Alfonso

Authors
  1. J. García-Medina
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  2. J. J. García-Alfonso
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Corresponding author

Correspondence to J. García-Medina.

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Conflicts of interest

J. García-Medina and J.J. García-Alfonso certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants and participation in speakers’ bureaus; membership, employment, consultancies, stock ownership or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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”. “Additional informed consent does not apply.”

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García-Medina, J., García-Alfonso, J. Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons. Cardiovasc Intervent Radiol 40, 750–754 (2017). https://doi.org/10.1007/s00270-016-1541-9

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  • DOI: https://doi.org/10.1007/s00270-016-1541-9

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