TY - JOUR
T1 - Predicting factors for successful maturation of autogenous haemodialysis fistulas after salvage percutaneous transluminal angioplasty in diabetic nephropathy
T2 - A study on follow-up doppler ultrasonography
AU - Jeon, Eui Yong
AU - Cho, Young Kwon
AU - Cho, Sung Bum
AU - Yoon, Dae Young
AU - Suh, Seong O.
N1 - Publisher Copyright:
© 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.
PY - 2015/12/30
Y1 - 2015/12/30
N2 - Background: Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality. Objectives: The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA. Patients and Methods: We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography). Results: The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation. Conclusion: For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.
AB - Background: Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality. Objectives: The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA. Patients and Methods: We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography). Results: The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation. Conclusion: For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.
KW - Angioplasty
KW - Arteriovenous fistula
KW - Autologous transplantation
KW - Doppler ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=84954434797&partnerID=8YFLogxK
U2 - 10.5812/iranjradiol.32559
DO - 10.5812/iranjradiol.32559
M3 - Article
AN - SCOPUS:84954434797
VL - 13
JO - Iranian Journal of Radiology
JF - Iranian Journal of Radiology
SN - 1735-1065
IS - 1
M1 - e32559
ER -