{"title":"Endovascular Stent Placement for Hemodialysis Arteriovenous Access Stenosis","authors":"B. Neuen, R. Baer, F. Grainer, M. Mantha","doi":"10.1155/2015/971202","DOIUrl":null,"url":null,"abstract":"This study aims to report the outcomes of nitinol and polytetrafluoroethylene covered stent placement to treat hemodialysis arteriovenous access stenosis at a single center over a five-year period. Clinical and radiological information was reviewed retrospectively. Poststent primary and secondary patency rates were determined using Kaplan-Meier analysis. Ten clinical variables were subjected to multivariate Cox regression analysis to determine predictors of patency after stent placement. During the study period 60 stents were deployed in 45 patients, with a mean follow-up of 24.5 months. The clinical and anatomical success rate was 98.3% (59/60). Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively. Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively. Stent placement for upper arm lesions and in access less than 12 months of age was associated with reduced primary patency (adjusted hazards ratio [HR] 5.1, p = 0.0084, and HR 3.5, p = 0.0029, resp.). Resistant or recurrent stenosis can be successfully treated by endovascular stent placement with durable long-term patency, although multiple procedures are often required. Stent placement for upper arm lesions and in arteriovenous access less than 12 months of age was associated with increased risk of patency loss.","PeriodicalId":14448,"journal":{"name":"International Journal of Vascular Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2015-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2015/971202","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Vascular Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2015/971202","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 3
Abstract
This study aims to report the outcomes of nitinol and polytetrafluoroethylene covered stent placement to treat hemodialysis arteriovenous access stenosis at a single center over a five-year period. Clinical and radiological information was reviewed retrospectively. Poststent primary and secondary patency rates were determined using Kaplan-Meier analysis. Ten clinical variables were subjected to multivariate Cox regression analysis to determine predictors of patency after stent placement. During the study period 60 stents were deployed in 45 patients, with a mean follow-up of 24.5 months. The clinical and anatomical success rate was 98.3% (59/60). Poststent primary patency rates at 6, 12, and 24 months were 64%, 46%, and 35%, respectively. Poststent secondary patency rates at 6, 12, and 24 months were 95%, 89%, and 85%, respectively. Stent placement for upper arm lesions and in access less than 12 months of age was associated with reduced primary patency (adjusted hazards ratio [HR] 5.1, p = 0.0084, and HR 3.5, p = 0.0029, resp.). Resistant or recurrent stenosis can be successfully treated by endovascular stent placement with durable long-term patency, although multiple procedures are often required. Stent placement for upper arm lesions and in arteriovenous access less than 12 months of age was associated with increased risk of patency loss.
本研究旨在报告镍钛诺和聚四氟乙烯覆盖支架放置治疗血液透析动静脉通道狭窄的结果,为期5年。回顾性回顾临床和放射学资料。采用Kaplan-Meier分析确定支架后一期和二期通畅率。对10个临床变量进行多变量Cox回归分析,以确定支架置入后通畅的预测因素。在研究期间,45名患者共植入了60个支架,平均随访24.5个月。临床和解剖成功率为98.3%(59/60)。支架后6个月、12个月和24个月的原发性通畅率分别为64%、46%和35%。支架后6个月、12个月和24个月的二次通畅率分别为95%、89%和85%。上臂病变和小于12个月的支架置入与原发性通畅降低相关(校正风险比[HR] 5.1, p = 0.0084, HR 3.5, p = 0.0029,分别对应)。顽固性或复发性狭窄可以通过血管内支架置入术成功治疗,并保持持久的长期通畅,尽管通常需要多次手术。在上臂病变和小于12个月的动静脉通路中放置支架与开放丧失的风险增加相关。