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KMID : 0882420060700050551
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Korean Journal of Medicine
2006 Volume.70 No. 5 p.551 ~ p.558
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Clinical factors affecting Long-term patency after percutaneous transluminal angioplasty of insufficient hemodialytic arteriovenous fistula
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이현철/Lee HC
현승혜/최지영/박자용/박성원/배호상/조영준/김찬덕/박선희/김용림/Hyun SH/Choi JY/Park JY/Park SW/Bae HS/Cho YJ/Kim CD/Park SH/Kim YL
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Abstract
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Background:The aim of this study is to evaluate success rate and patency rate after percutaneous transluminal angioplasty (PTA) and to determine the factors affecting patency rate afterPTA in the management of insufficient arteriovenous fistula of hemodialysis patients.
Methods:Ninety-two cases of insufficient arteriovenous fistulae in 73 hemodialysis patients underwent angiography of the fistula and were treatedby PTA (native AVF: 67 cases, AV graft: 10 cases, central vein: 15 cases). The initial success rate and complications of PTA were evaluated. All patients were divided into two groups according to the age, sex, the duration of hemodialysis, a history of diabetes mellitus, the numbers of AVF operation, and the presence or absenceof thrombus. The patency rate was compared with the Kaplan-Meier method with log-rank test. To determine the clinical factors that affect vascular access failure rate, Cox regression method was used.
Results:The initial success rate of PTA was 78.2% (72/92). The patency rate after successful PTA was 80.0% at 6 months, and 73.2% at 12 months. The patency rate after successful PTA was significantly lower in cases which had two or more AVF operation (62.3% and 48.5% at 6 and 12 months) than just one (87.8% and 80.5% at 6 and 12 months). The most common PTA related complications were vessel spasm (3.9%) and hematoma (3.9%).
Conclusions:The numbers of AVF operation was the only risk factor which affected the patency rate.
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