Erschienen in:
01.08.2003 | Clinical Investigations
Transluminally Placed Endovascular Grafts for Venous Lesions in
Patients on Hemodialysis
verfasst von:
S.F. Quinn, J. Kim, R.C. Sheley
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 4/2003
Einloggen, um Zugang zu erhalten
Abstract
This report summarizes a feasibility study of
transluminally placed endovascular grafts (TPEG) using pre-expanded
polytetrafluoroethylene (PTFE) to treat venous abnormalities in
patients on hemodialysis. Seventeen patients with peripheral
(n = 11) or central (n = 6) venous
lesions were treated with TPEG devices. Covered Gianturco stents were
used for the peripheral lesions and covered Palmaz stents were used for
central lesions. Venous abnormalities included vascular rupture after
balloon angioplasty or surgical thrombectomy (n = 4),
stenosis associated with an aneurysm (n = 2) and
occlusive disease and central stenoses not responsive to balloon
angioplasty (n = 11). The mean primary patency period
was 37 days. The mean secondary patency period was 215 days. At 60,
180, and 360 days the primary and secondary patency rates were 40%,
32%, and 32%, and 70%, 55%, and 39%, respectively. Follow-up
studies have shown various outcomes of the implanted TPEG devices,
which have included stenoses within the TPEG (n = 2),
stenoses central to the TPEG (n = 1), stenoses
peripheral to the TPEG (n = 3), acute thrombosis
extending to the TPEG without a stenosis (n = 1), graft
abandoned with patent TPEG (n = 6), and TPEG patent
within primary patency period at last follow-up (n =
4). The TPEG devices, made with pre-expanded PTFE, appear safe in
the short term, do not prevent progressive dialysis access site
failure, and need to be compared to PTA and endovascular stenting in a
randomized prospective trial.