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Percutaneous transluminal angioplasty in the treatment of stenosis of arteriovenous fistulae for hemodialysis

DOI: 10.1186/1755-7682-1-16

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To evaluate the primary patency of arteriovenous fistulae following percutaneous transluminal angioplasty.Patients submitted to percutaneous transluminal angioplasty in the Angiology service of Hospital de Base in 2004 were analyzed over an average follow-up of 10 months (2 to 16 months).A total of 22 angioplasties were performed in 20 fistulae of 19 patients. Of the 19 patients, one did not complete follow-up and one presented with a rupture of the fistulae. The following complications occurred in the remaining 18 fistulae, three deaths with two fistulae patent until death; one exeresis of prosthesis due to infection (53 days after the procedure); two thromboses (3 and 49 days after the procedure) and four restenosis (3 were submitted to a second angioplasty and one treated surgically). At the end of the follow-up, 11 fistulae (55%) were patent and with a flow rate in hemodialysis > 300 mL/min. Primary patency was 82.4% over three months; 81.2% over six months; 54.5% over 9 months and 50% over 1 year.Percutaneous transluminal angioplasty is an efficacious method for the correction of stenosis of arteriovenous fistulae for hemodialysis, prolonging the patency of the fistula and enabling new interventions.The increase in the prevalence of patients with chronic renal failure on hemodialysis has made several measures to maintain the vascular access patent and efficacious necessary as, the morbimortality of these patients is directly related to the effectiveness of hemodialysis. This requires repeated punctures of large vessels capable of offering a rapid blood flow of adequate volume [1-3].Thrombosis is the most frequent complication of arteriovenous fistulae that results in the loss of the access for hemodialysis. Most episodes of thrombosis coincide with the development of stenosis (in more than 85% of cases), generally located in the venous segment proximal to the arteriovenous anastomosis [4-6]. Stenosis in the arterial segment has been studied less but also compro


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