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Percutaneous Endovascular Treatment to Salvage Non-Maturing Arteriovenous Fistulas in a Multiethnic Asian Population.

Abstract An arteriovenous fistula (AVF) is the preferred method for haemodialysis in patients with end-stage renal failure. Previous studies have shown value in attempting percutaneous transluminal angioplasty (PTA) to salvage AVFs that fail to mature, but they are relatively small in size and mainly reported in Western populations. We reviewed our data of PTA in non-maturing AVFs to establish whether this technique is translatable to our local multiethnic population.
PMID
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Authors

Mayor MeshTerms

Arteriovenous Shunt, Surgical

Keywords
Journal Title annals of the academy of medicine, singapore
Publication Year Start




PMID- 28263343
OWN - NLM
STAT- MEDLINE
DA  - 20170306
DCOM- 20170314
LR  - 20170314
IS  - 0304-4602 (Print)
IS  - 0304-4602 (Linking)
VI  - 46
IP  - 2
DP  - 2017 Feb
TI  - Percutaneous Endovascular Treatment to Salvage Non-Maturing Arteriovenous
      Fistulas in a Multiethnic Asian Population.
PG  - 64-71
AB  - INTRODUCTION: An arteriovenous fistula (AVF) is the preferred method for
      haemodialysis in patients with end-stage renal failure. Previous studies have
      shown value in attempting percutaneous transluminal angioplasty (PTA) to salvage 
      AVFs that fail to mature, but they are relatively small in size and mainly
      reported in Western populations. We reviewed our data of PTA in non-maturing AVFs
      to establish whether this technique is translatable to our local multiethnic
      population. MATERIALS AND METHODS: We retrospectively reviewed the medical
      records and procedural images of 105 patients who had PTA for non-maturing AVFs
      performed at our department from January 2008 to January 2011. Technical success 
      was defined as &lt;/=30% residual stenosis after angioplasty. Clinical success was
      defined as at least 1 successful haemodialysis session within 4 weeks after PTA. 
      RESULTS: All 105 patients underwent angioplasty for at least 1 haemodynamically
      significant stenosis. Six (5.7%) had additional embolisation of accessory veins. 
      Technical success was achieved in 95.2% of cases. The clinical success rate was
      76.2%. Primary patency rates at 3, 6 and 12 months were 83%, 45% and 28%,
      respectively. Secondary patency rates at 3, 6 and 12 months were 90%, 79% and
      70%, respectively. The minor complication rate was 18.1%. No major complications 
      were encountered. An average of 1.7 interventions per access-year was required to
      maintain AVF patency. Patients with a preoperative vein size &gt;2.0 mm and age &lt;55 
      years were more likely to achieve clinical success, although not statistically
      significant. CONCLUSION: PTA is a viable option to help salvage non-maturing AVFs
      in a multiethnic Asian population.
FAU - Tham, Wei Ping
AU  - Tham WP
AD  - Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
FAU - Burgmans, Mark C
AU  - Burgmans MC
FAU - Tan, Bien Soo
AU  - Tan BS
FAU - Tay, Kiang Hong
AU  - Tay KH
FAU - Irani, Farah G
AU  - Irani FG
FAU - Gogna, Apoorva
AU  - Gogna A
FAU - Patel, Ankur
AU  - Patel A
FAU - Lo, Richard Hg
AU  - Lo RH
FAU - Chng, Siew Ping
AU  - Chng SP
FAU - Choong, Hui Lin
AU  - Choong HL
FAU - Chan, Shaun Xjm
AU  - Chan SX
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singapore
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
SB  - IM
MH  - Angioplasty/*methods
MH  - *Arteriovenous Shunt, Surgical
MH  - Constriction, Pathologic/*therapy
MH  - Embolization, Therapeutic
MH  - Female
MH  - Humans
MH  - Kidney Failure, Chronic/*therapy
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis
MH  - Reoperation
MH  - Retrospective Studies
MH  - Singapore
MH  - Veins
EDAT- 2017/03/07 06:00
MHDA- 2017/03/16 06:00
CRDT- 2017/03/07 06:00
PST - ppublish
SO  - Ann Acad Med Singapore. 2017 Feb;46(2):64-71.

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