Technical success rates and long-term patency of endovascular treatment for occluded native hemodialysis fistulas: comparison between thrombotic occlusion and nonthrombotic occlusion

• Published in: Japanese Journal of Radiology 2010-08, Vol.28 (7), p.512-519
• Main Authors: Miyayama, Shiro, Yamashiro, Masashi, Yoshie, Yuichi, Okuda, Miho, Nakashima, Yoshiko, Ikeno, Hiroshi, Orito, Nobuaki, Ueda, Naokazu, Kato, Tamayo, Ushiogi, Yasuyuki, Matsui, Osamu
• Format: Article
• Language: English
• Subjects: Aged; Angiography; Arteriovenous Shunt, Surgical; Chi-Square Distribution; Contrast Media; Female; Forearm - blood supply; Graft Occlusion, Vascular - therapy; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Original Article; Radiology; Radiotherapy; Renal Dialysis; Thrombosis - therapy; Treatment Outcome; Vascular Patency
• ISSN: 1867-1071; 1862-5274; 1867-108X
• DOI: 10.1007/s11604-010-0458-5

Purpose This study evaluated the technical success and long-term patency of endovascular treatment for occluded native hemodialysis fistulas caused by thrombotic occlusion (TO) and nonthrombotic occlusion (NTO). Materials and methods This cohort included 96 consecutive occlusions (70 TOs and 26 NTOs) at the forearm. Clinical success and patency rates of endovascular treatment were calculated and compared between the TO and NTO groups. Results Overall clinical success rate was 91.6%; and primary, assisted primary, and secondary patency rates at 1, 2, and 3 years were 49.6%, 30.7%, and 28.3%, respectively; 73.8%, 48.3%, and 48.3%, respectively; and 80.7%, 72.3%, and 66.2%, respectively. Clinical success rates of the TO and NTO groups were 91.4% and 92.3%, respectively. The 1-, 2-, and 3-year primary, assisted primary, and secondary patency rates of the TO group were 54.4%, 29.3%, and 25.6%, respectively; 70.7%, 49.4%, and 49.4%, respectively, and 78%, 68.8%, and 64,2%, respectively. Those of the NTO group were 38.9%, 32.4%, and 32.4%, respectively; 81.2%, 47.3%, and 40.6%, respectively; and 87%, 80.3%, and 70.2%, respectively. There were no significant differences between the clinical success and patency rates of the two groups. Conclusion Occluded native hemodialysis fistulas were restored with high frequency, without significant differences between clinical success and patency in the TO and NTO groups.