DIALYSIS ACCESS GRAFTS - ANATOMIC LOCATION OF VENOUS STENOSIS AND RESULTS ANGIOPLASTY

PURPOSE: To determine the distribution of stenoses and results of angioplasty in patients with similar forearm dialysis grafts made of polytetrafluoroethylene (PTFE). MATERIALS AND METHODS: Diagnostic radiographs of the fistula obtained in 215 patients were reviewed; 90 patients had similar, unrevised forearm PTFE loop dialysis grafts. The location, morphology, and results of angioplasty were reviewed for each measurable stenosis. Surgical, radiologic, and dialysis records were reviewed to document the subsequent patency rate of each patient's dialysis access. RESULTS: On the initial diagnostic fistulogram, 93 stenoses were identified, The anatomic distribution included 47% at the venous anastomosis and 11% within 1 cm of the anastomosis. Life table analysis revealed a 6-month patency rate of 63% and a 1-year patency rate of 41% for the first angioplasty in a given graft, and a 6-month patency rate of 50% and a 1-year patency rate of 25% for the second angioplasty. CONCLUSION: Performance of serial venous angioplasty procedures may help prolong the life of a graft, but the patency rates diminish with subsequent interventions.