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Titolo:
Balloon angioplasty for arteriovenous graft stenosis
Autore:
Anain, P; Shenoy, S; OBrien-Irr, M; Harris, LM; Dryjski, M;
Indirizzi:
State Univ New York Buffalo, Dept Surg, Buffalo, NY USA State Univ New York Buffalo Buffalo NY USA o, Dept Surg, Buffalo, NY USA State Univ New York Buffalo, Dept Radiol, Buffalo, NY USA State Univ New York Buffalo Buffalo NY USA Dept Radiol, Buffalo, NY USA Kaleida Hlth, Buffalo, NY USA Kaleida Hlth Buffalo NY USAKaleida Hlth, Buffalo, NY USA
Titolo Testata:
JOURNAL OF ENDOVASCULAR THERAPY
fascicolo: 2, volume: 8, anno: 2001,
pagine: 167 - 172
SICI:
1526-6028(200104)8:2<167:BAFAGS>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
THROMBOSED HEMODIALYSIS GRAFTS; TRANS-LUMINAL ANGIOPLASTY; VASCULAR ACCESS; SURGICAL THROMBECTOMY; DIALYSIS FISTULAS; SURVIVAL; REVISION; PATENCY;
Keywords:
AV access; hemodialysis; thrombolysis; thrombectomy; urokinase;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Dryjski, M Millard Fillmore Hosp, Dept Surg, KALEIDA Hlth, 3 Gates Circle,Buffalo, NY 14209 USA Millard Fillmore Hosp 3 Gates Circle Buffalo NY USA 14209 9 USA
Citazione:
P. Anain et al., "Balloon angioplasty for arteriovenous graft stenosis", J ENDOVAS T, 8(2), 2001, pp. 167-172

Abstract

Purpose: To retrospectively review the long-term outcome as well as the cost effectiveness of thrombolytic therapy and balloon angioplasty (TBA) versus surgical thrombectomy and balloon angioplasty (SBA) in the treatment of prosthetic dialysis access grafts. Methods: Between February 1996 and February 1999, 63 hemodialysis patients(35 women; mean age 62.2 years) were treated for 105 thromboses in 6-mm polytetrafluoroethylene straight or loop bridge arteriovenous grafts. Choice of treatment was at the discretion of the surgeon or interventional radiologist: either Fogarty balloon thrombectomy followed by balloon dilation of the venous anastomotic stenosis or urokinase thrombolysis followed by angioplasty. Results: Forty-eight SBAs and 55 TBAs were performed in 63 patients without complications. The primary patency rates in the entire cohort were 34%, 29%, and 17% at 1, 2, and 3 months, respectively. Primary patency after TEA was 29%, 18%, and 11%, and that for SEA, 45%, 45%, and 33% over the same time intervals. The mean graft survival was 10 days for TEA versus 31 days for SEA. Repeat angioplasty performed in 23 grafts produced secondary patencyrates of 52% at 1 month, 34% at 3 months, and 5% at 5 months. The Medicarereimbursement for both treatments was identical ($1638 for TEA and $1670 for SEA). Conclusions: The poor patency rate and high cost of TEA and SEA suggests that these procedures should not be routinely used for salvage of thrombosedarteriovenous grafts with outflow stenosis. Patch angioplasty or creation of simultaneous temporary and new permanent accesses may be a more cost-effective approach in these patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/02/20 alle ore 05:10:41