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Prof. Hisham Hussein Mohamed Ahmed :: Publications:

Sometimes Endovascular Salvage of Failing Hemodialysis Access Is Indispensable; As You Will Hardly Get Another
Authors: Hisham Ahmed, MD; El-Sayed A. Abd El-Mabood, MD; Refaat S. Salama, MD;
Year: 2016
Keywords: Failing Hemodialysis Access, Endovascular Salvage, Outcomes
Journal: Egyptian Journal of Surgery
Volume: Not Available
Issue: April2016
Pages: Not Available
Publisher: Not Available
Local/International: International
Paper Link: Not Available
Full paper Hisham Hussein Mohamed Ahmed_Sometimes Endovascular Salvage of Failing Hemodialysis Access Is Indispensable.pdf
Supplementary materials Not Available

Purposes: Aimed at salvaging fistulas using Percutaneous Transluminal balloon Angioplasty (PTA). To evaluate the feasibility and safety of this PTA. Patients and methods: Retrospective study was conducted on 15 patients to evaluate the results of endovascular intervention for the treatment of failing arteriovenous fistula from August 2015 till March 2016; these patients included 8 (53.3%) males and 7 (46.7%) females with age strata; most patients were aged between 40-60years. Results: Immediate success rate was 66.4 % in anastomotic stenosis, 75% in juxtaanastmotic stenosis and 100% in cases of Central venous & arterial stenosis. Success rate after 6 months was mostly 50% that necessitated RePTA except in central stenosis cases was 100%. Failed procedure was observed in 3 cases; 2 cases were due to puncture site hematoma & Vein or anastomotic site rupture; treated by open surgery and ligation of the artery & vein proximal and distal to the anastomosis; while thrombosis was the cause of failure of the 3rd case. Conclusions: Save access save life; Failing AV fistulas can be salvaged with PTA being safe and effective treatment. Results are obtained with less trauma to the patient, Preserves access sites, Less postprocedure pain and wound edema and Centrally located stenoses are accessible. RePTA is needed in half the patients.

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