Short-term outcomes of borderline stenoses in vascular accesses with PTFE grafts
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
19395732
DOI
10.1093/ndt/gfp195
PII: gfp195
Knihovny.cz E-resources
- MeSH
- Angioplasty, Balloon * MeSH
- Time Factors MeSH
- Blood Vessel Prosthesis adverse effects MeSH
- Renal Dialysis * MeSH
- Middle Aged MeSH
- Humans MeSH
- Vascular Diseases etiology therapy MeSH
- Polytetrafluoroethylene * MeSH
- Disease Progression MeSH
- Retrospective Studies MeSH
- Constriction, Pathologic etiology therapy MeSH
- Treatment Outcome MeSH
- Catheters, Indwelling adverse effects MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Polytetrafluoroethylene * MeSH
BACKGROUND: There are controversial data about vascular access stenosis surveillance by ultrasonography. The definition of stenosis significance varies among centres. We performed a retrospective study to describe short-term outcomes of borderline asymptomatic stenoses defined by precise criteria and to determine possible risk factors of stenosis progression. METHODS: We studied the outcome of borderline stenoses in accesses with PTFE grafts. Stenosis was considered significant if there was a combination of >50% lumen reduction and peak systolic ratio >2, together with at least one of the following additional criteria: (1) residual diameter <2.0 mm and (2) flow reduction of >25% or actual flow volume <600 ml/min. Stenosis was considered borderline in the absence of the additional criteria. RESULTS: Of the 102 borderline stenoses, after 11 +/- 6 weeks, 55 remained non-progressive, in 38 the degree of the stenosis progressed, in 8 a percutaneous transluminal angioplasty (PTA) was performed due to clinical indication and only 1 thrombosed. A significant relative risk of developing significant stenosis was found in grafts with prior PTA [RR = 1.91 (95% CI: 1.27, 2.88), P = 0.002] and in female gender [RR = 2.29, (95% CI: 1.29, 4.06), P = 0.025]. CONCLUSIONS: Delaying PTA of borderline stenoses is safe using this watch-and-wait strategy and stenoses remain stable over at least short time, but with higher risk of progression especially after prior PTA. We believe that the definition of precise criteria of stenosis significance is necessary for the benefit of ultrasound surveillance.
References provided by Crossref.org
Classifications of haemodialysis vascular access stenosis: a scoping review
Arteriovenous Hemodialysis Access Stenosis Diagnosed by Duplex Doppler Ultrasonography: A Review
The role of Doppler ultrasonography in vascular access surveillance-controversies continue
