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Nephrol Dial Transplant (2004) 19: 306-308
© ERA–EDTA 2004; all rights reserved

Personal Opinion

Stenosis and thrombosis in haemodialysis fistulae and grafts: the radiologist's point of view

Luc Turmel-Rodrigues

Departments of Cardiovascular Radiology, Clinique St-Gatien, Tours, Clinique St-Hilaire, Rouen, Hôpital Européen Georges Pompidou, Paris, France

Correspondence and offprint requests to: Luc Turmel-Rodrigues, Departments of Cardiovascular Radiology, Clinique St-Gatien, Tours, Clinique St-Hilaire, Rouen, Hôpital Européen Georges Pompidou, Paris, France. Email: luc.turmel@wanadoo.fr

Keywords: percutaneous transluminal angioplasty; stents and prostheses; thrombectomy; vascular access thrombosis

The first 10% of the full text of this article appears below.

All published series concerning percutaneous treatment of thrombosed native fistulae and prosthetic grafts report that an underlying tight stenosis is unmasked in the vast majority of cases, which means that preventive treatment of such stenoses would have avoided acute thrombosis. Vascular access stenosis and thrombosis can nowadays be routinely treated by interventional radiology techniques, which includes dilatation of stenoses with or without stent placement and many declotting techniques [1].

Vascular access dilatation and stent placement

Dilatation or percutaneous transluminal angioplasty is performed with catheters carrying inflatable balloons of different sizes (3–16 mm in dialysis access) and lengths (2–8 cm). Special balloons with rated burst pressures of 20 atm are often necessary to abolish the waist of hard fibrotic venous stenoses. Expensive balloons carrying microblades (‘cutting balloons’) can also be used.

Stents are extremely useful in selected indications but all reports show that they are not the . . . [Full Text of this Article]

Declotting of thrombosed accesses

Peripheral access stenosis and/or thrombosis: endovascular or surgical intervention?

How to approach problems with prosthetic grafts?

Respective success rates in native a-v fistulae with isolated stenosis

Delayed a-v fistula maturation associated with vessel stenosis

Importance of expertise and excellent imaging

Conclusion


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