Endovascular intervention in the maintenance and rescue of paediatric arteriovenous fistulae for hemodialysis.
Adolescent
Age Factors
Arteriovenous Shunt, Surgical
/ adverse effects
Child
Child, Preschool
Endovascular Procedures
/ adverse effects
Female
Graft Occlusion, Vascular
/ diagnosis
Humans
Male
Renal Dialysis
Renal Insufficiency, Chronic
/ diagnosis
Retrospective Studies
Risk Assessment
Risk Factors
Stents
Time Factors
Treatment Outcome
Vascular Patency
Angioplasty
Arteriovenous fistulas
Endovascular
Haemodialysis
Vascular access
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
16
07
2018
accepted:
06
11
2018
revised:
31
10
2018
pubmed:
30
11
2018
medline:
28
4
2020
entrez:
29
11
2018
Statut:
ppublish
Résumé
Arteriovenous fistulae (AVF) provide superior primary vascular access for children on chronic dialysis compared to central venous catheters (CVC). However, AVFs inevitably develop complications and will require some intervention to maintain long-term functional patency. We report an 'endovascular-first' approach to the maintenance and rescue of paediatric AVFs. Thirty interventions targeting 46 lesions in 18 children (median age 11 years [range 5-17]) were performed. Sixty-eight percent of the AVFs were brachio-cephalic fistulae, 26% brachio-basilic fistulae and 5% radio-cephalic fistulae. Immediate functional success was 86% with good dialysis adequacy (mean urea reduction ratio > 70%) at 3 months post procedure. There was one significant complication, consisting of an AVF rupture which was managed with a covered stent. Repeated interventions may be necessary to maintain AVF patency and avoid central venous catheters. This is the largest series reported to date.
Sections du résumé
BACKGROUND
Arteriovenous fistulae (AVF) provide superior primary vascular access for children on chronic dialysis compared to central venous catheters (CVC). However, AVFs inevitably develop complications and will require some intervention to maintain long-term functional patency.
METHODS
We report an 'endovascular-first' approach to the maintenance and rescue of paediatric AVFs. Thirty interventions targeting 46 lesions in 18 children (median age 11 years [range 5-17]) were performed. Sixty-eight percent of the AVFs were brachio-cephalic fistulae, 26% brachio-basilic fistulae and 5% radio-cephalic fistulae. Immediate functional success was 86% with good dialysis adequacy (mean urea reduction ratio > 70%) at 3 months post procedure.
RESULTS
There was one significant complication, consisting of an AVF rupture which was managed with a covered stent.
CONCLUSIONS
Repeated interventions may be necessary to maintain AVF patency and avoid central venous catheters. This is the largest series reported to date.
Identifiants
pubmed: 30483965
doi: 10.1007/s00467-018-4143-8
pii: 10.1007/s00467-018-4143-8
pmc: PMC6394687
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
723-727Références
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