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< Vol. 14 Issue 3 | Jul-Sep 2013 | pp. 209 - 306

Ultrasound-guided endovascular treatment for vascular access malfunction: results in 4896 cases

Ultrasound-guided endovascular treatment for vascular access malfunction: results in 4896 cases

J Vasc Access 2013; 14(3): 225 - 230

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jva.5000126

Authors

Masanori Wakabayashi, Sayaka Hanada, Hiroyuki Nakano, Tsunemichi Wakabayashi

Abstract

Purpose: For the protracted maintenance of vascular access, countermeasures against stenosis are important. Between March 2004 and October 2011 superficial ultrasound-guided percutaneous transluminal angioplasty (PTA) was performed in our hospital for arteriovenous fistula malfunction in 4869 cases in 1011 patients, and the utility of the treatment was assessed on the basis of early results. In cases where vascular intervention was deemed necessary, the procedure was conducted under ultrasound guidance as first option, with fluoroscopy and radiography used additionally as necessary.
Methods: The ultrasound apparatus used was primarily the 11 MHz linear-type probe (GE-Yokogawa Logiq S6). For subclavian and brachiocephalic veins, the microconvex-type probe was used to visualize the lesion through the intercostal space. In obstruction cases, ultrasound-guided PTA was performed after superficial ultrasound-guided aspiration or thrombus removal. 
Results: In stenosis cases, early success (technical and clinical) was obtained in 4288 of 4414 cases (97.1%). In obstruction cases, early success was obtained in 443 cases and 91.9% for obstruction cases. Assistance by intra-operative fluoroscopy or radiography was required in 55 cases, and surgical reconstruction was required in 42 cases. Serious complications occurred in 12 of 4869 cases (0.2%).
Conclusions: Ultrasound-guided PTA for arteriovenous fistula malfunction could be used as a substitute for fluoroscopy-guided PTA, and enables the use of safe and rapid intervention techniques.

Article History

  • • Accepted on 18/10/2012
  • • Available online on 08/01/2013
  • • Published in print on 01/10/2013

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Authors

  • Wakabayashi, Masanori [PubMed] [Google Scholar]
    Department of Vascular Surgery, Bousei The First Clinic, Numadu, Shizuoka - Japan
  • Hanada, Sayaka [PubMed] [Google Scholar]
    Department of Vascular surgery, Tobu Hospital, Gotenba, Shizuoka - Japan
  • Nakano, Hiroyuki [PubMed] [Google Scholar]
    Kakitagawa The First Clinic, Shimizucho, Shizuoka - Japan
  • Wakabayashi, Tsunemichi [PubMed] [Google Scholar]
    Department of Internal Medicine, Fuji Hospital, Gotenba, Shizuoka - Japan

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