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- W2081567982 abstract "Pseudoaneurysm (PSA) formation is a complication of hemodialysis access. Open repair requires PSA resection, interposition graft placement, and insertion of a catheter as a bridge. Endovascular stent graft repair is an alternative that permits immediate use of the access site. The objective of this study was to determine the efficacy of stent grafts for repair of arteriovenous fistula (AVF) and graft (AVG) PSA. A retrospective review of medical records from October 2007 to December 2010 revealed 21 patients with a PSA who underwent endovascular repair using a stent graft. Indications for repair included PSA with symptoms (n= 12), PSA with skin erosion (n=8), PSA with failed hemodialysis (n=3), and PSA after balloon angioplasty of a stenosis (n=1). Outcome measures were technical success, 30-day and 180-day patency, secondary interventions, and complications. Twenty-four self expanding stent grafts (Viabahn, WL Gore n=22; Fluency, Bard n=2) were used to treat hemodialysis access (AVG n=12, AVF n=9) PSA in 21 patients (14 females, mean age=55.3 yrs, mean BMI=28.3, mean PSA diameter 17.9 mm). Co-morbidities included hypertension (n=19, 91.4%) and diabetes mellitus (n=8, 38.1%). The median time from access creation to repair was 455 days. The technical success rate was 100%. The 30 and 180 day patency rate was 100% and 69.2%, respectively. Two secondary interventions were performed for treatment of unrelated stenosis. Treatment failure occurred in 5 (20.8%) stent grafts due to infection (n=3) and thrombosis (n=2). Treatment of PSA with skin erosion was associated with failure due to infection (OR 3.3, 95% CI 0.41, 26.34). The remaining 19 (79.2%) stent grafts remain patent. The mean follow up time was 299 days (median 126). Endovascular treatment of hemodialysis access PSA using stent grafts is an effective and durable option. PSA with skin erosion may increase the risk of failure due to infection." @default.
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- W2081567982 date "2011-06-01" @default.
- W2081567982 modified "2023-09-30" @default.
- W2081567982 title "SS16. Endovascular Treatment of Hemodialysis Access Pseudoaneurysms: A Single Institution Experience" @default.
- W2081567982 doi "https://doi.org/10.1016/j.jvs.2011.03.053" @default.
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