scholarly journals The findings of optical coherence tomography before and after percutaneous transluminal angioplasty for vascular access restenosis lesions

2017 ◽  
Vol 50 (2) ◽  
pp. 147-152
Author(s):  
Yuki Horita
Keyword(s):  
Optical Coherence Tomography ◽  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Optical Coherence ◽  
Before And After ◽  
Percutaneous Transluminal

Arterial percutaneous angioplasty in hemodialysis access: Endovascular treatment of hand ischemia

2020 ◽  
pp. 112972982094665
Author(s):  
Gabriela Teixeira ◽  
Paulo Almeida ◽  
Luís Loureiro ◽  
Inês Antunes ◽  
Duarte Rego ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Clinical Success ◽  
Invasive Procedure ◽  
Transluminal Angioplasty ◽  
Arterial Stenosis ◽  
Low Flow ◽  
Hemodialysis Access ◽  
Percutaneous Transluminal

Background: Hemodialysis access–induced distal ischemia consists of symptomatic extremity malperfusion after vascular access creation. It is usually caused by discordant vascular resistance, with arteriovenous shunting of a high blood volume from arterial into venous system and subsequent hand hypoperfusion. Less often, hemodialysis access–induced distal ischemia is caused by arterial stenosis. In these cases, access frequently has normal/low flow, radial pulse is usually absent and not recoverable with vascular access digital compression, diabetes is often present, and percutaneous transluminal angioplasty can be critical for access and limb salvage. Methods: Retrospective study conducted between June 2011 and February 2018 of patients with vascular access submitted to arterial percutaneous transluminal angioplasty for limb-threatening ischemia. Results: Twenty-nine patients were referred for arterial angiography after hemodialysis access–induced distal ischemia diagnosis and physical examination or ultrasound findings suggestive of arterial disease. In 11 patients, percutaneous transluminal angioplasty was not technically feasible. Among 18 treated patients, 83.3% had diabetes and 60% had skin ulcerations. Target arteries were radial (11), brachial (7), axillar (2), ulnar (2), and subclavian (1). Clinical success, defined as arteriovenous maintenance and wound healing/pain resolution, was observed in 12 patients (66.7%). Concomitant procedures included adjuvant banding ( n = 2) and finger amputation ( n = 1), and one reintervention was performed. No intra- or postoperative complications were reported. Conclusion: Hemodialysis access–induced distal ischemia is a serious complication of hemodialysis vascular access, with multifactorial etiology. Correct and timely diagnosis is crucial for maintaining access and limb salvage. Percutaneous transluminal angioplasty is a minimally invasive procedure that may be effective and long-lasting in carefully selected patients with ischemic complaints.

Percutaneous transluminal angioplasty (PTA) and venous stenting in hemodialysis patients with vascular access-related venous stenosis or occlusion

Radiography ◽  
2006 ◽  
Vol 12 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Fotini P. Christidou ◽  
Vasilios I. Kalpakidis ◽  
Kostas D. Iatrou ◽  
Ioannis A. Zervidis ◽  
Gerasimos I. Bamichas ◽  
...  
Keyword(s):  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Hemodialysis Patients ◽  
Transluminal Angioplasty ◽  
Venous Stenting ◽  
Venous Stenosis ◽  
Percutaneous Transluminal

scholarly journals Current state of dialysis treatment and vascular access management in Japan

2019 ◽  
Vol 20 (1_suppl) ◽  
pp. 10-14 ◽  
Author(s):  
Takashi Sato ◽  
Hiroshi Sakurai ◽  
Kentaro Okubo ◽  
Risa Kusuta ◽  
Takeshi Onogi ◽  
...  
Keyword(s):  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Japanese Society ◽  
Transluminal Angioplasty ◽  
Access Management ◽  
Dialysis Therapy ◽  
Arteriovenous Fistulae ◽  
First Choice ◽  
Dialysis Outcomes ◽  
Percutaneous Transluminal

According to the data from the Japanese Society for Dialysis Therapy, the number of dialysis patients was about 330,000 at the end of 2016. The mean age of newly initiated patients was 69.4 years and that of maintenance was 68.2 years. And, diabetic nephropathy is the most common primary disease, with an incidence rate of 43.2%. These results mean that the systemic vascular condition is getting worse. In spite of these backgrounds, the patients of 97.3% were treated by hemodialysis; therefore, careful management of vascular access is essential to better maintain the condition of patients. The Dialysis Outcomes and Practice Patterns Study shows that vascular access modalities are an important factor in determining prognoses of patients and that prognosis in Japan is one of the best worldwide. In Japan, the use of arteriovenous fistulae accounts for 95% of vascular access modalities. However, a statistic by Japanese Society for Dialysis Therapy suggests that the use of arteriovenous graft has been increasing. In 2005, Japanese Society for Dialysis Therapy Guidelines recommended percutaneous transluminal angioplasty be the first choice for the treatment of vascular access stenosis. Since then, percutaneous transluminal angioplasty has become an important procedure for long-term maintenance of the morphology and function of vascular access. In Japan, approximately 60% of percutaneous transluminal angioplasty are conducted by nephrologists and urologists; in addition, arteriovenous fistulae creation procedures are also performed by them. According to my private opinion, such conditions above show that even in the absence of standardized training on vascular access management, doctors on site perform their duties in an appropriate manner. However, the problems of how we evaluate the specificity in Japan and pass it down the generations still remain.

Angioscopy before and after percutaneous transluminal angioplasty

1994 ◽  
Vol 26 (4) ◽  
pp. 256-259
Author(s):  
F. W. Winkelbauer ◽  
T. Hölzenbein ◽  
M. E. Ammann ◽  
G. Kretschmer ◽  
J. Lammer
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Before And After ◽  
Percutaneous Transluminal

Percutaneous Transluminal Angioplasty as Best Treatment in Stenosis of Vascular Access for Hemodialysis

Nephron ◽  
1989 ◽  
Vol 51 (2) ◽  
pp. 192-196 ◽  
Author(s):  
J.C. Rodriguez-Perez ◽  
M. Maynar ◽  
A. Rams ◽  
C. Plaza ◽  
N. Vega ◽  
...  
Keyword(s):  
Vascular Access ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Percutaneous Transluminal

Hemodynamic Effect of Percutaneous Transluminal Angioplasty for Lower Limb Atherosclerosis

1987 ◽  
Vol 28 (6) ◽  
pp. 761-766 ◽  
Author(s):  
J. J. Jørgensen ◽  
E. Stranden ◽  
T. Gjølberg
Keyword(s):  
Flow Velocity ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Arterial Flow ◽  
Functional Evaluation ◽  
Ankle Pressure ◽  
Before And After ◽  
Pulsed Wave Doppler ◽  
The Common ◽  
Percutaneous Transluminal

Measurements of ankle pressure index (API) and arterial flow velocity including calculation of pulsatility index (PI) from the common femoral and pedal arteries were performed in 89 limbs of 75 patients before and after percutaneous transluminal angioplasty (PTA) (63 iliac and 26 femoropopliteal). A pulsed wave Doppler ultrasound flowmeter was used. An increase of API at rest of at least 0.15 or the absence of pressure drop after exercise following PTA was used as criteria for a hemodynamically successful angioplasty. In patients with hemodynamically successful PTA of an iliac obstruction PI increased from 4.2 to 8.6 (p<0.001); 91 per cent of these patients improved clinically. When iliac angioplasty was hemodynamically unsuccessful, PI remained unchanged; 11 per cent of these patients improved clinically. All limbs with hemodynamically successful PTA of a femoropopliteal obstruction improved clinically and PI increased from 3.1 to 8.7 (p<0.001). After hemodynamically unsuccessful femoropopliteal PTA, PI remained unchanged though 25 per cent of these patients improved clinically. These results illustrate that measurement of arterial flow velocity with calculation of PI may be a useful supplement for the functional evaluation of the effect of PTA, since symptomatic response alone may be unreliable.

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