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DOI: 10.1055/s-0035-1549844
A Practical Review of the Use of Stents for the Maintenance of Hemodialysis Access
Publikationsverlauf
Publikationsdatum:
28. Mai 2015 (online)
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In the last two decades, there has been a dramatic increase in stent placement for dialysis access venous stenosis, in-stent stenosis, aneurysms and pseudoaneuryms, and angioplasty-induced vascular rupture. At this point, there is level 1 evidence for SG superiority over PTA for venous stenosis in AV grafts and in-stent stenosis in both AV grafts and AV fistulae. Given significant updates in evidence for stent use and considerable advancement in stent technology, we feel that an update of KDOQI clinical practice guidelines, which have not been revised in over 8 years, is in order. Although recent data for stent use in AV fistula lesions are promising, at present, we do not routinely deploy stents in this setting as a primary treatment. Until further large prospective, randomized controlled trials are conducted to assess primary stenting of venous stenosis in the setting of AV fistulas, our preference remains PTA as a primary treatment for AV fistula dysfunction.
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References
- 1 U.S. Renal Data System. USRDS 2010 Annual Data Report. Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010
- 2 Gilbertson DT, Liu J, Xue JL , et al. Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J Am Soc Nephrol 2005; 16 (12) 3736-3741
- 3 Konner K, Hulbert-Shearon TE, Roys EC, Port FK. Tailoring the initial vascular access for dialysis patients. Kidney Int 2002; 62 (1) 329-338
- 4 The economic cost of ESRD, vascular access procedures, and Medicare spending for alternative modalities of treatment. Am J Kidney Dis 1997; 30: 160-177
- 5 Vassalotti JA, Jennings WC, Beathard GA , et al; Fistula First Breakthrough Initiative Community Education Committee. Fistula first breakthrough initiative: targeting catheter last in fistula first. Semin Dial 2012; 25 (3) 303-310
- 6 The Fistula First Breakthrough Initiative Available at: http://esrdncc.org/ffcl/ . Accessed December 20, 2012
- 7 Lacson Jr E, Wang W, Hakim RM, Teng M, Lazarus JM. Associates of mortality and hospitalization in hemodialysis: potentially actionable laboratory variables and vascular access. Am J Kidney Dis 2009; 53 (1) 79-90
- 8 Xue H, Ix JH, Wang W , et al. Hemodialysis access usage patterns in the incident dialysis year and associated catheter-related complications. Am J Kidney Dis 2013; 61 (1) 123-130
- 9 Lee T, Roy-Chaudhury P. Advances and new frontiers in the pathophysiology of venous neointimal hyperplasia and dialysis access stenosis. Adv Chronic Kidney Dis 2009; 16 (5) 329-338
- 10 Yevzlin A, Asif A. Stent placement in hemodialysis access: historical lessons, the state of the art and future directions. Clin J Am Soc Nephrol 2009; 4 (5) 996-1008
- 11 Chan MR, Bedi S, Sanchez RJ , et al. Stent placement versus angioplasty improves patency of arteriovenous grafts and blood flow of arteriovenous fistulae. Clin J Am Soc Nephrol 2008; 3 (3) 699-705
- 12 Vogel PM, Parise C. Comparison of SMART stent placement for arteriovenous graft salvage versus successful graft PTA. J Vasc Interv Radiol 2005; 16 (12) 1619-1626
- 13 Zaleski GX, Funaki B, Rosenblum J, Theoharis J, Leef J. Metallic stents deployed in synthetic arteriovenous hemodialysis grafts. AJR Am J Roentgenol 2001; 176 (6) 1515-1519
- 14 Rhodes ES, Silas AM. Dialysis needle puncture of Wallgrafts placed in polytetrafluoroethylene hemodialysis grafts. J Vasc Interv Radiol 2005; 16 (8) 1129-1134
- 15 Vesely TM. Use of stent grafts to repair hemodialysis graft-related pseudoaneurysms. J Vasc Interv Radiol 2005; 16 (10) 1301-1307
- 16 Pandolfe LR, Malamis AP, Pierce K, Borge MA. Treatment of hemodialysis graft pseudoaneurysms with stent grafts: institutional experience and review of the literature. Semin Intervent Radiol 2009; 26 (2) 89-95
- 17 Ayus JC, Sheikh-Hamad D. Silent infection in clotted hemodialysis access grafts. J Am Soc Nephrol 1998; 9 (7) 1314-1317
- 18 Delorme JM, Guidoin R, Canizales S , et al. Vascular access for hemodialysis: pathologic features of surgically excised ePTFE grafts. Ann Vasc Surg 1992; 6 (6) 517-524
- 19 National Kidney Foundation. KDOQI clinical practice guidelines and clinical practice recommendations for 2006. Updates: Hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Available at: http://www.kidney.org/sites/default/files/docs/12-50-0210_jag_dcp_guidelines-hd_oct06_sectiona_ofc.pdf . Accessed April 15, 2015
- 20 Quinn SF, Schuman ES, Demlow TA , et al. Percutaneous transluminal angioplasty versus endovascular stent placement in the treatment of venous stenoses in patients undergoing hemodialysis: intermediate results. J Vasc Interv Radiol 1995; 6 (6) 851-855
- 21 Beathard GA. Gianturco self-expanding stent in the treatment of stenosis in dialysis access grafts. Kidney Int 1993; 43 (4) 872-877
- 22 Hoffer EK, Sultan S, Herskowitz MM, Daniels ID, Sclafani SJA. Prospective randomized trial of a metallic intravascular stent in hemodialysis graft maintenance. J Vasc Interv Radiol 1997; 8 (6) 965-973
- 23 Haskal ZJ, Trerotola S, Dolmatch B , et al. Stent graft versus balloon angioplasty for failing dialysis-access grafts. N Engl J Med 2010; 362 (6) 494-503
- 24 Haskal ZJ. Twelve month results of the RENOVA trial: a prospective multicenter randomized, concurrently-controlled comparison of the Flair® endovascular stent graft vs. balloon angioplasty in dialysis access grafts. J Vasc Interv Radiol 2013; 24 (4) S5
- 25 Haskal Z. 24-month final results from the RENOVA study: a randomized controlled comparison of stent grafts and balloon angioplasty for dialysis access graft preservation. J Vasc Interv Radiol 2014; 25 (3) S6
- 26 Vesely T, DaCanzo W, Behrend T, Dwyer A, Aruny J REVISE Clinical Trial: Presentation at the ASDIN 10th Annual Scientific Meeting; 2014
- 27 Salman L, Asif A. Stent graft for nephrologists: concerns and consensus. Clin J Am Soc Nephrol 2010; 5 (7) 1347-1352
- 28 Sick PB, Brosteanu O, Niebauer J, Hehrlein C, Schuler G. Neointima formation after stent implantation in an experimental model of restenosis: polytetrafluoroethylene-covered versus uncovered stainless steel stents. Heart Dis 2002; 4 (1) 18-25
- 29 Dolmatch BL, Tio FO, Li XD, Dong YH. Patency and tissue response related to two types of polytetrafluoroethylene-covered stents in the dog. J Vasc Interv Radiol 1996; 7 (5) 641-649
- 30 Falk A, Maya ID, Yevzlin AS. Six-month results of the RESCUE trial: FLUENCY® PLUS Endovascular Stent Graft versus PTA for In-stent Restenosis. J Vasc Interv Radiol 2014; 25 (4) 661
- 31 Rajan DK, Clark TWI, Patel NK, Stavropoulos SW, Simons ME. Prevalence and treatment of cephalic arch stenosis in dysfunctional autogenous hemodialysis fistulas. J Vasc Interv Radiol 2003; 14 (5) 567-573
- 32 Kian K, Asif A. Cephalic arch stenosis. Semin Dial 2008; 21 (1) 78-82
- 33 Kian K, Unger SW, Mishler R, Schon D, Lenz O, Asif A. Role of surgical intervention for cephalic arch stenosis in the “fistula first” era. Semin Dial 2008; 21 (1) 93-96
- 34 Shemesh D, Goldin I, Zaghal I, Berlowitz D, Raveh D, Olsha O. Angioplasty with stent graft versus bare stent for recurrent cephalic arch stenosis in autogenous arteriovenous access for hemodialysis: a prospective randomized clinical trial. J Vasc Surg 2008; 48 (6) 1524-1531 , 1531.e1–1531.e2
- 35 Barshes NR, Annambhotla S, Bechara C , et al. Endovascular repair of hemodialysis graft-related pseudoaneurysm: an alternative treatment strategy in salvaging failing dialysis access. Vasc Endovascular Surg 2008; 42 (3) 228-234
- 36 Shemesh D, Goldin I, Zaghal I, Berelowitz D, Verstandig AG, Olsha O. Stent graft treatment for hemodialysis access aneurysms. J Vasc Surg 2011; 54 (4) 1088-1094
- 37 Pasklinsky G, Meisner RJ, Labropoulos N , et al. Management of true aneurysms of hemodialysis access fistulas. J Vasc Surg 2011; 53 (5) 1291-1297
- 38 Funaki B, Szymski GX, Leef JA, Rosenblum JD, Burke R, Hackworth CA. Wallstent deployment to salvage dialysis graft thrombolysis complicated by venous rupture: early and intermediate results. AJR Am J Roentgenol 1997; 169 (5) 1435-1437
- 39 Dale JD, Dolmatch BL, Duch JM, Winder R, Davidson IJ. Expanded polytetrafluoroethylene-covered stent treatment of angioplasty-related extravasation during hemodialysis access intervention: technical and 180-day patency. J Vasc Interv Radiol 2010; 21 (3) 322-326
- 40 Kundu S. Review of central venous disease in hemodialysis patients. J Vasc Interv Radiol 2010; 21 (7) 963-968
- 41 Verstandig AG, Berelowitz D, Zaghal I , et al. Stent grafts for central venous occlusive disease in patients with ipsilateral hemodialysis access. J Vasc Interv Radiol 2013; 24 (9) 1280-1287 , quiz 1288