DIALYSIS ACCESS GRAFTS - ANATOMIC LOCATION OF VENOUS STENOSIS AND RESULTS ANGIOPLASTY

PURPOSE: To determine the distribution of stenoses and results of angi oplasty in patients with similar forearm dialysis grafts made of polyt etrafluoroethylene (PTFE). MATERIALS AND METHODS: Diagnostic radiograp hs of the fistula obtained in 215 patients were reviewed; 90 patients had similar, unrevised forearm PTFE loop dialysis grafts. The location , morphology, and results of angioplasty were reviewed for each measur able stenosis. Surgical, radiologic, and dialysis records were reviewe d to document the subsequent patency rate of each patient's dialysis a ccess. RESULTS: On the initial diagnostic fistulogram, 93 stenoses wer e identified, The anatomic distribution included 47% at the venous ana stomosis and 11% within 1 cm of the anastomosis. Life table analysis r evealed a 6-month patency rate of 63% and a 1-year patency rate of 41% for the first angioplasty in a given graft, and a 6-month patency rat e of 50% and a 1-year patency rate of 25% for the second angioplasty. CONCLUSION: Performance of serial venous angioplasty procedures may he lp prolong the life of a graft, but the patency rates diminish with su bsequent interventions.