ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 82-88

Ultrasound-assisted angioplasty for failing arteriovenous access


Division of Peripheral Vascular and Endovascular Sciences, Medanta – The Medicity Hospital, Gurgaon, Haryana, India

Correspondence Address:
Dr. Shahzad Sarosh Bulsara
Division of Peripheral Vascular and Endovascular Sciences, Medanta – The Medicity Hospital, Gurgaon, Haryana
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_72_18

Rights and Permissions

Introduction: Arteriovenous (AV) access maturity and patency is critical for patients on hemodialysis. Maintaining a functioning AV access for these patients is of paramount importance. Salvage of failing AV accesses has been traditionally done mainly with angiographic techniques requiring significant amounts of contrast agent and radiation exposure. Ultrasound-guided angioplasty has been described, but its utility needs to be further studied. Methods: Group 1: 42 patients undergoing ultrasound-assisted angioplasty (UAA) for AV access salvage were assessed prospectively for 9 months (October 2016 to June 2017). Group 2: Retrospective data of 47 patients who underwent angioplasty for failing AV access without ultrasound assistance, over 9 months was collected (January to September 2016). This group was matched with Group 1 in terms of age, sex, type of AV access, and cause of AV access dysfunction. Results: There was a statistically significant decrease in the average number of angiographic runs (2.5 vs. 7.9) and fluoroscopy time in minutes (3.8 vs. 13.1) recorded during UAA (P < 0.01). The average quantity of contrast agent used in milliliters (17.6 vs. 49.8) was also significantly less when ultrasound assistance was used (P < 0.01). Conclusion: UAA for failing AV access reduces the radiation exposure and the amount of contrast agent used in these patients who require multiple of these sessions and need dialysis to get the contrast agent out of their circulation. This technique is feasible and reliable; hence should be used more frequently and effectively. Our model of UAA for AV access salvage allows all cases including complex cases to be performed with the added advantage of reduced radiation exposure and contrast agent; serving as a boon to these already distressed patients. Immediate complication management and adjunctive open procedures also become possible because of the hybrid operating room setup with fluoroscopy facility.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed66    
    Printed0    
    Emailed0    
    PDF Downloaded6    
    Comments [Add]    

Recommend this journal