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Percutaneous transluminal angioplasty of a non-mainstream venous route to restore an occluded hemodialysis fistula

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Abstract

Purpose

To report the usefulness of percutaneous transluminal angioplasty (PTA) of a non-mainstream venous route in an occluded native hemodialysis fistula when a mainstream outflow vein could not be traversed.

Materials and methods

This cohort included seven patients with an occulted hemodialysis fistula with difficulty in traversing via a mainstream route. A non-mainstream vein near the occluded portion was traversed until it connected with a proximal large-sized vein and the route was dilated using a 4- or 5-mm balloon catheter. Metallic stent placement was performed, if necessary. Technical aspects and long-term patency was evaluated.

Results

PTA could be performed in all patients; however, stent placement was required in two because of residual stenosis and clotting. The clinical success rate of fistula restoration was 100 %. Fistula dysfunction recurred in six patients 17–668 days (mean ± standard deviation 229.3 ± 225.0) later. PTA was repeated in four patients, but not in two. The mean duration of the primary patency was 336.6 ± 417.2 days (range 17–1,190) and that of the secondary patency was 897.1 ± 801.4 days (range 17–2,230).

Conclusion

PTA of a non-mainstream venous route is useful for restoring an occluded hemodialysis fistula when the mainstream outflow vein cannot be traversed.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan

    Shiro Miyayama, Masashi Yamashiro, Masaya Ikuno, Kenichiro Okumura & Miki Yoshida

  2. Department of Internal Medicine, Fukuiken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui, 918-8503, Japan

    Tamayo Kato & Yasuyuki Ushiogi

Authors
  1. Shiro Miyayama
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  2. Masashi Yamashiro
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  3. Masaya Ikuno
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  4. Kenichiro Okumura
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  5. Miki Yoshida
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  6. Tamayo Kato
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  7. Yasuyuki Ushiogi
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Corresponding author

Correspondence to Shiro Miyayama.

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Miyayama, S., Yamashiro, M., Ikuno, M. et al. Percutaneous transluminal angioplasty of a non-mainstream venous route to restore an occluded hemodialysis fistula. Jpn J Radiol 32, 117–122 (2014). https://doi.org/10.1007/s11604-013-0277-6

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  • DOI: https://doi.org/10.1007/s11604-013-0277-6

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