%0 Journal Article
%T Interwoven Nitinol Stents to Treat Radiocephalic Anastomotic Arteriovenous Fistula Stenosis
%A Phillip Crowe
%A Ramon L. Varcoe
%A Samantha Peden
%A Shannon D. Thomas
%J Journal of Endovascular Therapy
%@ 1545-1550
%D 2019
%R 10.1177/1526602819842851
%X Purpose: To determine the clinical outcomes in hemodialysis patients after implantation of a Supera stent to treat juxta-anastomotic stenosis in radiocephalic arteriovenous fistulas (AVF). Materials and Methods: A single-center retrospective study was conducted of 42 consecutive patients (mean age 66.7 years, range 40¨C84; 26 men) who had a failing AVF due to juxta-anastomotic stenosis treated with the interwoven Supera stent between February 2014 and February 2018. A third of the patients had previous juxta-anastomotic intervention (either balloon angioplasty or open surgical revision). Results: The stent was inserted successfully in all patients. Overall mean follow-up was 12.2¡À8.2 months (range 3.8¨C38.3). Juxta-anastomotic segment primary patency estimates at 6 and 12 months were 92.5% and 59.8%, respectively, with assisted primary patency rates of 97.5% and 92.9%. Reintervention (elective drug-coated balloon angioplasty) occurred at a rate of 0.31 procedures/year. Two AVFs thrombosed during the 1-year follow-up and were revascularized using balloon angioplasty. Ultrasound measurements of brachial artery flow rates increased significantly from 543.5¡À96.72 mL/min (range 430¨C644) before intervention to 919.2¡À355.9 mL/min (range 200¨C1600) after intervention (p=0.047). Arterial pressures on hemodialysis improved from £¿142.3¡À24.9 mm Hg (range £¿100 to £¿180) to £¿123.4¡À21.9 mm Hg (range £¿100 to £¿184; p=0.051). No AVFs were lost or abandoned during the follow-up period. Conclusion: The interwoven Supera stent is a promising treatment for failing AVFs with juxta-anastomotic stenosis. Encouraging 1-year primary and assisted primary patency was demonstrated, with a low reintervention rate. This treatment facilitates long-term maintenance of AVF vascular accesses
%K arteriovenous fistula
%K hemodialysis
%K interwoven stent
%K juxta-anastomotic stenosis
%K radiocephalic dialysis access
%K reintervention
%K restenosis
%K vascular access
%U https://journals.sagepub.com/doi/full/10.1177/1526602819842851