Turk Kardiyol Dern Ars. 2020; 48(8): 754-759 | DOI: 10.5543/tkda.2020.33027
Percutaneous angioplasty in the treatment of thrombosed hemodialysis fistulas: A single-center experience with 1 year of follow-up
, Ersan Tatlı1
, Ahmed Bilal Genç3
, Selçuk Yaylacı3
, Salih Şahinkuş1
, Muhammed Necati Murat Aksoy1
, Mustafa Tarık Ağaç1
, Hamad Dheir2
, Savaş Sipahi21
Department of Cardiology, Sakarya University Faculty of Medicine, Adapazarı, Turkey2
Department of Internal Medicine, Sakarya University Faculty of Medicine, Adapazarı, Turkey3
Department of Nephrology, Sakarya University Faculty of Medicine, Adapazarı, Turkey
OBJECTIVE Thrombosis of a hemodialysis arteriovenous fistula (AVF) is a serious complication that needs urgent treatment. Most cases are treated surgically, but recently, endovascular strategies have become a viable alternative. This study is an evaluation of the success and patency rate of percutaneous balloon angioplasty of thrombosed hemodialysis fistulas using a drug-coated balloon (DCB) contrasted with a standard balloon (SB).
METHODS The data of 33 patients with a thrombosed native hemodialysis AVF treated percutaneously in a tertiary care center were analyzed retrospectively. Success of the procedure was defined as restoration of flow with less than 30% residual stenosis and resumption of dialysis through the hemodialysis AVF. The success rate of the procedure and the patency rate at 1, 6, and 12 months were evaluated. The effect on patency of a DCB was compared to that of a SB.
RESULTS Twenty-five radiocephalic and 8 brachiocephalic thrombosed hemodialysis AVFs were treated during the study period. Flow was restored in 23 thrombosed fistulas, a success rate of 69.7%. The patency rate of successfully treated fistulas was 95.6% at 1 month, 76.1% at 6 months, and 57.9% at 12 months. Ten of the 23 re-established AVFs were treated with a DCB and the remainder were treated with a SB. The patency of the fistulas treated with a DCB was similar to that of a SB at 1 month (100% vs 92.3%, respectively; p=0.393). The patency rate of a DCB was greater than that of a SB at 6 months (88.9% vs 66.7%, respectively; p=0.258) and 12 months (75% vs 45.4%, respectively; p=0.219).
CONCLUSION Percutaneous intervention for thrombosed hemodialysis AVFs is a safe, minimally invasive, and effective procedure. There was a positive trend in the patency rate of patients treated with a DCB at 6 and 12 months compared with a SB.
Arteriovenous fistula, percutaneous treatment; thrombosis.
How to cite this article
Ibrahim Kocayigit, Ersan Tatlı, Ahmed Bilal Genç, Selçuk Yaylacı, Salih Şahinkuş, Muhammed Necati Murat Aksoy, Mustafa Tarık Ağaç, Hamad Dheir, Savaş Sipahi. Percutaneous angioplasty in the treatment of thrombosed hemodialysis fistulas: A single-center experience with 1 year of follow-up. Turk Kardiyol Dern Ars. 2020; 48(8): 754-759
Corresponding Author: Ibrahim Kocayigit, Türkiye