VENOUS RUPTURE COMPLICATING HEMODIALYSIS ACCESS ANGIOPLASTY - PERCUTANEOUS TREATMENT AND OUTCOMES IN 7 PATIENTS

OBJECTIVE. To evaluate percutaneous treatment options for preserving h emodialysis access after angioplasty-related venous rupture, we retros pectively reviewed the charts for all dialysis access angioplasties pe rformed over a 33-month period. Seven cases of venous rupture after ve nous angioplasty were identified (four men and three women; mean age, 63.5 years). Treatment included observation only (n = 1), a second pro longed balloon inflation at the rupture site (n = 2), stent insertion (n = 5), and manual graft occlusion (n = 1). Treatment was successful in eliminating contrast extravasation in all patients while maintainin g immediate graft function in six out of seven patients. None of the p atients required emergent surgical intervention. The mean primary and secondary patency rates of the salvaged grafts after intervention were 2.3 and 9.3 months, respectively. Five of seven access sites were sti ll patent at the most recent follow-up. CONCLUSION. Prolonged balloon inflation or placement of a stent may salvage hemodialysis access in m ost patients after angioplasty-related venous rupture. Primary and sec ondary patency have proven to be satisfactory.