Prevention of hemodialysis fistula thrombosis. Early detection of venous stenoses
- 1 October 1989
- journal article
- Published by Elsevier BV in Kidney International
- Vol. 36 (4), 707-711
- https://doi.org/10.1038/ki.1989.250
Abstract
Prevention of hemodialysis fistula thrombosis. Early detection of venous stenoses. Venous dialysis pressures were measured consecutively in 168 chronic hemodialysis patients for 265 patient-years of monitored dialysis. Venous dialysis pressure > 150mm Hg measured by the protocol were considered elevated. Seventy-three patients had elevated venous dialysis pressures and 58 agreed to undergo elective venography (fistulogram). Fifty of 58 patients studied (86%) had significant venous stenoses. A combination of percutaneous transluminal angioplasty (PTA) and surgical revision were used to electively treat these stenoses. Early detection and treatment of these stenoses decreased fistula thrombosis and fistula replacement threefold compared with our earlier experiences. Patients with elevated venous dialysis pressure who were venogramed and treated had an occurrence of fistula thrombosis similar to patients with normal dialysis pressure (0.15 and 0.13 episodes per patient year of dialysis respectively, P = NS). In contrast patients with elevated venous dialysis pressure who refused elective fistulogram and treatment averaged 1.4 episodes of thrombosis per patient year of dialysis (P < 0.001 compared to both other groups). We conclude that elevated venous dialysis pressure is a reliable method of detecting fistula stenoses and that the elective treatment of these stenoses significantly decreases fistula thrombosis and fistula lossKeywords
This publication has 9 references indexed in Scilit:
- Hemodialysis-associated subclavian vein stenosisKidney International, 1988
- The Role of Percutaneous Angioplasty in the Management of Chronic Hemodialysis FistulasAnnals of Surgery, 1987
- Transluminal angioplasty of venous stenoses in polytetrafluoroethylene vascular access graftsKidney International, 1987
- Vascular Access for Hemodialysis Patency Rates and Results of RevisionAnnals of Surgery, 1985
- Dialysis access fistulas: treatment of stenoses by transluminal angioplasty.Radiology, 1984
- Failing arteriovenous dialysis fistulas: evaluation and treatment.Radiology, 1984
- Percutaneous Transluminal AngioplastyArchives of Surgery, 1984
- Treatment of stenotic lesions in dialysis access fistulas and shunts by transluminal angioplasty.Radiology, 1982
- Expanded Polytetrafluoroethylene Graft Fistula for Chronic HemodialysisAnnals of Surgery, 1979