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KMID : 1103720130680030205
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Journal of the Korean Society of Radiology
2013 Volume.68 No. 3 p.205 ~ p.211
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The Impact of Anastomotic Angle for Re-Occlusion of Brachioaxillary Graft Arteriovenous Fistula after Percutaneous Thromboaspiration
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Kim Keon-Young
Choi Eun-Jung
Song Ji-Soo
Jin Gong-Yong
Hwang Seung-Bae
Han Young-Min
Kwon Keun-Sang
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Abstract
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Purpose: The purpose of this study is to evaluate the factors that affect graft patency in brachioaxillary graft arteriovenous fistula patients.
Materials and Methods: A retrospective study was conducted on 33 patients (20 men, 13 women; mean age, 67.5 years; mean interval to first stenosis, 17 months), who had performed percutaneous angioplasty for first episode of stenosis after brachioaxillary graft surgery. We evaluated the relevant factors affecting the graft patency after first episode of stenosis, such as age, sex, underlying disease (hypertension, diabetes mellitus, hyperlipidemia, cardiovascular disease, cerebrovascular attack), anastomotic angle between graft and axillary vein, and anastomotic angle between the graft and brachial artery. Kaplan-Meier method and log rank test and receiver operating characteristics curve analysis were used in statistical analysis.
Results: Graft patency rates after 1 month, 6 months, and 12 months were 75.8%, 39.4%, and 9.1%. There was a correlation between graft-axillary vein anastomotic angle and patency rates (r = 0.372, p = 0.033); larger the venous anastomotic angle, the longer patency rate. However, it does not come up with significant results in patency rates on age, sex, underlying disease, and graft-brachial artery angle.
Conclusion: In patients with brachioaxillary graft arteriovenous fistula, as venous anastomotic angle more obtuse, the graft patency may be longer.
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KEYWORD
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Arteriovenous Fistula, Percutaneous Transluminal Angioplasty, Vascular Patency, Thrombectomy, Surgical Anastomosis
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