There are limited data regarding endovascular treatment of arteriovenous graft (AVG) pseudoaneurysms using stent grafts. We performed a comprehensive literature review on the use of stent grafts in the treatment of AVG pseudoaneurysms. We included 10 studies (121 patients). The mean AVG age was 3.1 years (95% confidence interval [CI]: 2.2-4) and pseudoaneurysm mean diameter was 34 mm (95% CI: 23-46). The majority (71%) of the pseudoaneurysms were located on the arterial limb of the AVG and 77% presented with venous anastomosis stenosis requiring angioplasty. The mean number of stents used to treat one lesion was 1.4 (95% CI: 1.3-1.5). The technical success rate of pseudoaneurysm isolation was 100% in all studies and 100% of patients received hemodialysis using the AVG after pseudoaneurysm treatment without the need for catheter placement. The primary patency rates for 1, 3, and 6 months were 81%, 73%, and 24%. Secondary patency was 80%, 77%, and 74% at 1, 3, and 6 months. Arteriovenous graft thrombosis occurred in 12% of patients. Arteriovenous graft infection developed in 35% of cases. Arteriovenous graft pseudoaneurysm treatment using stent grafts is effective in managing even large pseudoaneurysms and has acceptable primary and secondary patency rates. Graft infection was a relatively frequent complication.
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http://dx.doi.org/10.1111/hdi.12152 | DOI Listing |
J Mark Access Health Policy
March 2025
BHF Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA, UK;
This study illustrates the utility of a mixed-methods approach in assessing the value of an example novel technology-biosensor-integrated self-reporting arteriovenous grafts (smart AVGs). Currently in preclinical development, the device will detect arteriovenous graft stenosis (surveillance-only use case) and treat stenosis (interventional use case). The approach to value assessment adopted in this study was multifaceted, with one stage informing the next and comprised a stakeholder engagement with clinical experts to explore the device's clinical value, a cost-utility analysis (CUA) from a US Medicare perspective to estimate pricing headroom, and an investment model estimating risk-adjusted net present value analysis (rNPVs) to determine commercial viability.
View Article and Find Full Text PDFPort J Card Thorac Vasc Surg
January 2025
Department of Cardiothoracic and Vascular Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Introduction: Arteriovenous (AV) fistula creation is the most common surgical procedure for providing vascular access for haemodialysis in patients with chronic kidney disease (CKD). The functioning of fistula dictates the quality of dialysis and the longevity of patients. The most common circumstances that require surgical takedown of AV fistula are thrombosis and rupture.
View Article and Find Full Text PDFNefrologia (Engl Ed)
January 2025
Servicios de Nefrología, Unidad Funcional de Acceso Vascular, Hospital Clínico de Barcelona, Barcelona, Spain.
Background And Objectives: The key points of a monographic vascular access (VA) consultation are an adequate preoperative assessment, as well as a correct management and optimization of waiting lists. Our main objective of present study was to evaluate the degree of exploratory-dependent concordance in outpatient clinics regarding implanted VA, between nephrology and vascular surgery.
Materials And Methods: We analyzed VA created or surgically repaired between 2021 and 2022.
Eur J Vasc Endovasc Surg
January 2025
Department of Surgery, Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA, USA.
Objective: This retrospective, single centre, comparative effectiveness study aimed to compare the long term outcomes of percutaneous arteriovenous fistulae (pAVF) and surgically created arteriovenous fistulae (sAVF) created in the proximal forearm for haemodialysis access.
Methods: Data were reviewed from a prospectively maintained database on patients who underwent pAVF or sAVF creation from September 2017 to September 2023. A total of 217 pAVFs (61 WavelinQ and 156 Ellipsys) and 158 sAVFs were analysed.
Case Rep Nephrol Dial
December 2024
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Introduction: A common complication of arteriovenous fistula (AVF) is thrombosis in the venous segment, which can impair vascular access unless a successful thrombectomy is performed.
Case Presentation: In this manuscript, we describe the case of a diabetic patient who had primary AVF in a snuff-box with subsequent superficialization of the medial vein of the forearm. Unfortunately, this section of the vein was occluded, although the fistula was patent through the cephalic vein (CV).
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