Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 1/2013

01.02.2013 | Clinical Investigation

Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft

verfasst von: Andrew Shawyer, Nicos I. Fotiadis, Girish Namagondlu, Arun Iyer, Mark Blunden, Martin Raftery, Magdi Yaqoob

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Cephalic arch stenosis (CAS) is an important and common cause of dysfunction in autogenous haemodialysis fistulas that requires multiple reinterventions and aggressive surveillance. We evaluated the safety and efficacy of the Viabahn stent-graft for the management of CAS.

Methods

Between April 2005 and October 2011, 11 consecutive patients [four men and seven women (mean age 56.7 years)] with CAS and dysfunctional fistulas were treated with insertion of 11 Viabahn stent-grafts. Six stent-grafts were inserted due to residual stenosis after angioplasty and five for fistuloplasty-induced rupture. No patient was lost to follow-up.

Results

The technical and clinical success rate was 100 %. Primary access patency rates were 81.8 % [95 % confidence interval (CI) 0.482–0.977] at 6 months and 72.7 % (95 % CI 0.390–0.939) at 12 months. Secondary access patency rates were 90.9 % at 6 months (95 % CI 0.587–0.997). There were no procedure-related complications. Mean follow-up was 543.8 days (range 156–2,282).

Conclusion

The use of the Viabahn stent-graft in the management of CAS is technically feasible and, in this small series, showed patency rates that compare favorably with historical data of angioplasty and bare stents.
Literatur
1.
Zurück zum Zitat Eknoyan G, Levin NW, Eschbach JW et al (2001) Continuous quality improvement: DOQI becomes K/DOQI and is updated. National Kidney Foundation Dialysis Outcomes Initiative. Am J Kidney Dis 37:179–194PubMedCrossRef Eknoyan G, Levin NW, Eschbach JW et al (2001) Continuous quality improvement: DOQI becomes K/DOQI and is updated. National Kidney Foundation Dialysis Outcomes Initiative. Am J Kidney Dis 37:179–194PubMedCrossRef
2.
Zurück zum Zitat NKF-DOQI (1997) Clinical practice guidelines for vascular access. National Kidney Foundation-Dialysis Outcomes Quality Initiative. Am J Kidney Dis 30(4 Suppl 3):S150–S191 NKF-DOQI (1997) Clinical practice guidelines for vascular access. National Kidney Foundation-Dialysis Outcomes Quality Initiative. Am J Kidney Dis 30(4 Suppl 3):S150–S191
4.
Zurück zum Zitat Hammes M, Funaki B, Coe FL (2008) Cephalic arch stenosis in patients with fistula access for hemodialysis: Relationship to diabetes and thrombosis. Hemodial Int 12(1):85–89PubMedCrossRef Hammes M, Funaki B, Coe FL (2008) Cephalic arch stenosis in patients with fistula access for hemodialysis: Relationship to diabetes and thrombosis. Hemodial Int 12(1):85–89PubMedCrossRef
5.
Zurück zum Zitat Rajan DK, Clark TW, Patel NK, Stavropoulos SW, Simons ME (2003) Prevalence and treatment of cephalic arch stenosis in dysfunctional autogenous hemodialysis fistulas. J Vasc Interv Radiol 14(5):567–573PubMedCrossRef Rajan DK, Clark TW, Patel NK, Stavropoulos SW, Simons ME (2003) Prevalence and treatment of cephalic arch stenosis in dysfunctional autogenous hemodialysis fistulas. J Vasc Interv Radiol 14(5):567–573PubMedCrossRef
6.
Zurück zum Zitat Jaberi A, Schwartz D, Marticorena R, Dacouris N, Prabhudesai V, McFarlane P et al (2007) Risk factors for the development of cephalic arch stenosis. J Vasc Access 8(4):287–295PubMed Jaberi A, Schwartz D, Marticorena R, Dacouris N, Prabhudesai V, McFarlane P et al (2007) Risk factors for the development of cephalic arch stenosis. J Vasc Access 8(4):287–295PubMed
7.
Zurück zum Zitat Bent CL, Rajan DK, Tan K, Simons ME, Jaskolka J, Kachura J et al (2010) Effectiveness of stent-graft placement for salvage of dysfunctional arteriovenous hemodialysis fistulas. J Vasc Interv Radiol 21(4):496–502PubMedCrossRef Bent CL, Rajan DK, Tan K, Simons ME, Jaskolka J, Kachura J et al (2010) Effectiveness of stent-graft placement for salvage of dysfunctional arteriovenous hemodialysis fistulas. J Vasc Interv Radiol 21(4):496–502PubMedCrossRef
8.
Zurück zum Zitat Vogel PM, Parise C (2004) SMART stent for salvage of hemodialysis access grafts. J Vasc Interv Radiol 15:1051–1060PubMedCrossRef Vogel PM, Parise C (2004) SMART stent for salvage of hemodialysis access grafts. J Vasc Interv Radiol 15:1051–1060PubMedCrossRef
9.
Zurück zum Zitat Vogel PM, Parise C (2005) Comparison of SMART stent placement for arteriovenous graft salvage versus successful graft PTA. J Vasc Interv Radiol 16:1619–1626PubMedCrossRef Vogel PM, Parise C (2005) Comparison of SMART stent placement for arteriovenous graft salvage versus successful graft PTA. J Vasc Interv Radiol 16:1619–1626PubMedCrossRef
10.
Zurück zum Zitat Gray RJ, Sacks D, Martin LG, Trerotola SO, Society of Interventional Radiology Technology Assessment Committee (2003) Reporting standards for percutaneous interventions in dialysis access. J Vasc Interv Radiol 14:S433–S442PubMedCrossRef Gray RJ, Sacks D, Martin LG, Trerotola SO, Society of Interventional Radiology Technology Assessment Committee (2003) Reporting standards for percutaneous interventions in dialysis access. J Vasc Interv Radiol 14:S433–S442PubMedCrossRef
11.
Zurück zum Zitat Fluck R, Kumwenda M (2011) Renal Association Clinical Practice Guideline on vascular access for haemodialysis. Nephron Clin Pract 118(Suppl 1):c225–c240PubMedCrossRef Fluck R, Kumwenda M (2011) Renal Association Clinical Practice Guideline on vascular access for haemodialysis. Nephron Clin Pract 118(Suppl 1):c225–c240PubMedCrossRef
12.
Zurück zum Zitat Tordoir J, Canaud B, Haage P et al (2007) European best practice guidelines (EBPG) on vascular access. Nephrol Dial Transpl 22(Suppl 2):ii88–ii117CrossRef Tordoir J, Canaud B, Haage P et al (2007) European best practice guidelines (EBPG) on vascular access. Nephrol Dial Transpl 22(Suppl 2):ii88–ii117CrossRef
13.
Zurück zum Zitat Kim DS, Kim SW, Kim JC, Cho JH, Kong JH, Park CR (2011) Clinical analysis of hemodialysis vascular access: comparision of autogenous arterioveonus fistula and arteriovenous prosthetic graft. Korean J Thorac Cardiovasc Surg 44(1):25–31PubMedCrossRef Kim DS, Kim SW, Kim JC, Cho JH, Kong JH, Park CR (2011) Clinical analysis of hemodialysis vascular access: comparision of autogenous arterioveonus fistula and arteriovenous prosthetic graft. Korean J Thorac Cardiovasc Surg 44(1):25–31PubMedCrossRef
14.
Zurück zum Zitat Wali MA, Eid RA, Dewan M, Al-Homrany MA (2003) Intimal changes in the cephalic vein of renal failure patients before arterio-venous fistula (AVF) construction. J Smooth Muscle Res 4:95–105CrossRef Wali MA, Eid RA, Dewan M, Al-Homrany MA (2003) Intimal changes in the cephalic vein of renal failure patients before arterio-venous fistula (AVF) construction. J Smooth Muscle Res 4:95–105CrossRef
15.
Zurück zum Zitat Tricht IV, Wachter DD, Tordoir J, Verdonck P (2005) Hemodynamics and complications encountered with arteriovenous fistulas and grafts as vascular access for hemodialysis: a review. Ann Biomech Eng 33:1142–1157CrossRef Tricht IV, Wachter DD, Tordoir J, Verdonck P (2005) Hemodynamics and complications encountered with arteriovenous fistulas and grafts as vascular access for hemodialysis: a review. Ann Biomech Eng 33:1142–1157CrossRef
16.
Zurück zum Zitat Roy-Chaudhury P, Sukhatme VP, Cheung AK (2006) Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol 17:1112–1127PubMedCrossRef Roy-Chaudhury P, Sukhatme VP, Cheung AK (2006) Hemodialysis vascular access dysfunction: a cellular and molecular viewpoint. J Am Soc Nephrol 17:1112–1127PubMedCrossRef
17.
Zurück zum Zitat Vascular Access Work Group (2006) Clinical practice guidelines for vascular access. Am J Kidney Dis 48(Suppl 1):S248–S273 Vascular Access Work Group (2006) Clinical practice guidelines for vascular access. Am J Kidney Dis 48(Suppl 1):S248–S273
18.
Zurück zum Zitat Rajan DK, Bunston S, Misra S, Pinto R, Lok CE (2004) Dysfunctional autogenous hemodialysis fistulas: Outcomes after angioplasty—are there clinical predictors of patency? Radiology 232(2):508–515PubMedCrossRef Rajan DK, Bunston S, Misra S, Pinto R, Lok CE (2004) Dysfunctional autogenous hemodialysis fistulas: Outcomes after angioplasty—are there clinical predictors of patency? Radiology 232(2):508–515PubMedCrossRef
19.
Zurück zum Zitat Manninen HI, Kaukanen ET, Ikaheimo R et al (2001) Brachial arterial access: endovascular treatment of failing Brescia-Cimino hemodialysis fistulas—initial success and long-term results. Radiology 218:711–718PubMed Manninen HI, Kaukanen ET, Ikaheimo R et al (2001) Brachial arterial access: endovascular treatment of failing Brescia-Cimino hemodialysis fistulas—initial success and long-term results. Radiology 218:711–718PubMed
20.
Zurück zum Zitat Clark TW, Hirsch DA, Jindal KJ, Veugelers PJ, LeBlanc J (2002) Outcome and prognostic factors of restenosis after percutaneous treatment of native hemodialysis fistulas. J Vasc Interv Radiol 13:51–59PubMedCrossRef Clark TW, Hirsch DA, Jindal KJ, Veugelers PJ, LeBlanc J (2002) Outcome and prognostic factors of restenosis after percutaneous treatment of native hemodialysis fistulas. J Vasc Interv Radiol 13:51–59PubMedCrossRef
21.
Zurück zum Zitat Kariya S, Tanigawa N, Kojima H, Komemushi A, Shomura Y, Shiraishi T et al (2007) Primary patency with cutting and conventional balloon angioplasty for different types of hemodialysis access stenosis. Radiology 243(2):578–587PubMedCrossRef Kariya S, Tanigawa N, Kojima H, Komemushi A, Shomura Y, Shiraishi T et al (2007) Primary patency with cutting and conventional balloon angioplasty for different types of hemodialysis access stenosis. Radiology 243(2):578–587PubMedCrossRef
22.
Zurück zum Zitat Heerwagen ST, Lönn L, Schroeder TV, Hansen MA (2010) Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: results of cutting balloon angioplasty. J Vasc Access 11(1):41–45PubMed Heerwagen ST, Lönn L, Schroeder TV, Hansen MA (2010) Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: results of cutting balloon angioplasty. J Vasc Access 11(1):41–45PubMed
23.
Zurück zum Zitat Wu CC, Lin MC, Pu SY, Tsai KC, Wen SC (2008) Comparison of cutting balloon versus high-pressure balloon angioplasty for resistant venous stenoses of native hemodialysis fistulas. J Vasc Interv Radiol 19(6):877–883PubMedCrossRef Wu CC, Lin MC, Pu SY, Tsai KC, Wen SC (2008) Comparison of cutting balloon versus high-pressure balloon angioplasty for resistant venous stenoses of native hemodialysis fistulas. J Vasc Interv Radiol 19(6):877–883PubMedCrossRef
24.
Zurück zum Zitat Gray RJ, Varma JD, Cho SS, Brown LC (2008) Pilot study of cryoplasty with use of PolarCath peripheral balloon catheter system for dialysis access. J Vasc Interv Radiol 19(10):1406–1460CrossRef Gray RJ, Varma JD, Cho SS, Brown LC (2008) Pilot study of cryoplasty with use of PolarCath peripheral balloon catheter system for dialysis access. J Vasc Interv Radiol 19(10):1406–1460CrossRef
25.
Zurück zum Zitat Chen JC, Kamal DM, Jastrzebski J, Taylor DC (2005) Venovenostomy for outflow venous obstruction in patients with upper extremity autogenous hemodialysis arteriovenous access. Ann Vasc Surg 19:629–635PubMedCrossRef Chen JC, Kamal DM, Jastrzebski J, Taylor DC (2005) Venovenostomy for outflow venous obstruction in patients with upper extremity autogenous hemodialysis arteriovenous access. Ann Vasc Surg 19:629–635PubMedCrossRef
26.
Zurück zum Zitat Spergel LM, Ravani P, Roy-Chaudhury P, Asif A, Besarab A (2007) Surgical salvage of the autogenous arteriovenous fistula (AVF). J Nephrol 20(4):388–398PubMed Spergel LM, Ravani P, Roy-Chaudhury P, Asif A, Besarab A (2007) Surgical salvage of the autogenous arteriovenous fistula (AVF). J Nephrol 20(4):388–398PubMed
27.
Zurück zum Zitat Chang CJ, Ko PJ, Hsu LA, Ko YS, Ko YL, Chen CF et al (2004) Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: implication in prevention of restenosis. Am J Kidney Dis 43:74–84PubMedCrossRef Chang CJ, Ko PJ, Hsu LA, Ko YS, Ko YL, Chen CF et al (2004) Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: implication in prevention of restenosis. Am J Kidney Dis 43:74–84PubMedCrossRef
28.
Zurück zum Zitat Hoffer EK, Sultan S, Herskowitz MM, Daniels ID, Sclafani SJ (1997) Prospective randomized trials of metallic intravascular stent in hemodialysis graft maintenance. J Vasc Interv Radiol 8:965–973PubMedCrossRef Hoffer EK, Sultan S, Herskowitz MM, Daniels ID, Sclafani SJ (1997) Prospective randomized trials of metallic intravascular stent in hemodialysis graft maintenance. J Vasc Interv Radiol 8:965–973PubMedCrossRef
29.
Zurück zum Zitat Patel RI, Peck SH, Cooper SG et al (1998) Patency of Wallstents placed across the venous anastomosis of hemodialysis grafts after percutaneous recanalization. Radiology 209:365–370PubMed Patel RI, Peck SH, Cooper SG et al (1998) Patency of Wallstents placed across the venous anastomosis of hemodialysis grafts after percutaneous recanalization. Radiology 209:365–370PubMed
30.
Zurück zum Zitat Kornfield ZN, Kwak A, Soulen MC, Patel AA, Kobrin SM, Cohen RM et al (2009) Incidence and management of percutaneous transluminal angioplasty-induced venous rupture in the “fistula first” era. J Vasc Interv Radiol 20(6):744–751PubMedCrossRef Kornfield ZN, Kwak A, Soulen MC, Patel AA, Kobrin SM, Cohen RM et al (2009) Incidence and management of percutaneous transluminal angioplasty-induced venous rupture in the “fistula first” era. J Vasc Interv Radiol 20(6):744–751PubMedCrossRef
31.
Zurück zum Zitat Haskal ZJ, Trerotola S, Dolmatch B, Schuman E, Altman S, Mietling S et al (2010) Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med 362(6):494–503PubMedCrossRef Haskal ZJ, Trerotola S, Dolmatch B, Schuman E, Altman S, Mietling S et al (2010) Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med 362(6):494–503PubMedCrossRef
32.
Zurück zum Zitat Chan MG, Miller FJ, Valji K, Kuo MD (2011) Evaluation of expanded polytetrafluoroethylene-covered stents for the treatment of venous outflow stenosis in hemodialysis access grafts. J Vasc Interv Radiol 22(5):647–653PubMedCrossRef Chan MG, Miller FJ, Valji K, Kuo MD (2011) Evaluation of expanded polytetrafluoroethylene-covered stents for the treatment of venous outflow stenosis in hemodialysis access grafts. J Vasc Interv Radiol 22(5):647–653PubMedCrossRef
33.
Zurück zum Zitat Shemesh D, Goldin I, Zaghal I, Berlowitz D, Raveh D, Olsha O (2008) 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 48(6):1524–1531PubMedCrossRef Shemesh D, Goldin I, Zaghal I, Berlowitz D, Raveh D, Olsha O (2008) 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 48(6):1524–1531PubMedCrossRef
Metadaten
Titel
Cephalic Arch Stenosis in Autogenous Haemodialysis Fistulas: Treatment With the Viabahn Stent-Graft
verfasst von
Andrew Shawyer
Nicos I. Fotiadis
Girish Namagondlu
Arun Iyer
Mark Blunden
Martin Raftery
Magdi Yaqoob
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 1/2013
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-012-0433-x

Weitere Artikel der Ausgabe 1/2013

CardioVascular and Interventional Radiology 1/2013 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.