| [ Summary ] |
Stenosis is the most common complication observed in hemodialysis fistulas. It has traditionally been managed with surgery. However, percutaneous transluminal angioplasty (PTA) has been used frequently in recent years. The need for improvements in patency rates after PTA is a major issue. Patency rates after initial PTAs for arteriovenous fistula (AVF) are 74 % at 6 months and 67 % at 12 months, and those for arteriovenous grafts (AVG) are 53 % at 6 months and 26 % at 12 months. There is no significant difference between the first and second PTAs for both AVF and AVG, patency rates for AVG tend to decrease after two or more procedures. Since AVG leads to outflow vein stenosis within a short time after AVG creation and PTA for AVG exhibits low patency rates, we examined the usefulness of stent replacement on patency rates for AVG. As a result, stenting prolonged the patency rate only when the stent was replaced. In the case of restenosis after stent replacement, the patency rate was remarkably lower than that for stent replacement. In addition to stenosis at the outflow vein, in-graft stenosis is another issue associated with AVG. These results suggest that percutaneous management of dysfunctional AVG is often more difficult than that for AVF. |