Radiology, Vol 195, 135-139, Copyright © 1995 by Radiological Society of North America
Dialysis access grafts: anatomic location of venous stenosis and results of angioplasty [published erratum appears in Radiology 1995 Aug;196(2):582]
RY Kanterman, TM Vesely, TK Pilgram, BW Guy, DW Windus and D Picus
Department of Radiology, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO 63110.
PURPOSE: To determine the distribution of stenoses and results of
angioplasty in patients with similar forearm dialysis grafts made of
polytetrafluoroethylene (PTFE). MATERIALS AND METHODS: Diagnostic
radiographs of the fistula obtained in 215 patients were reviewed; 90
patients had similar, unrevised forearm PTFE loop dialysis grafts. The
location, morphology, and results of angioplasty were reviewed for each
measurable stenosis. Surgical, radiologic, and dialysis records were
reviewed to document the subsequent patency rate of each patient's dialysis
access. RESULTS: On the initial diagnostic fistulogram, 93 stenoses were
identified. The anatomic distribution included 47% at the venous
anastomosis and 11% within 1 cm of the anastomosis. Life table analysis
revealed a 6-month patency rate of 63% and a 1-year patency rate of 41% for
the first angioplasty in a given graft, and a 6-month patency rate of 44%
and a 1-year patency rate of 22% [corrected] for the second angioplasty.
CONCLUSION: Performance of serial venous angioplasty procedures may help
prolong the life of a graft, but the patency rates diminish with subsequent
interventions.
