PATENCY OF WALLSTENTS PLACED ACROSS THE VENOUS ANASTOMOSIS OF HEMODIALYSIS GRAFTS AFTER PERCUTANEOUS RECANALIZATION

PURPOSE: To determine the patency of Wallstents placed across the veno us anastomosis of prosthetic bridge grafts after percutaneous graft re canalization. MATERIALS AND METHODS: Wallstents were placed across les ions at the venous anastomosis of polytetrafluoroethylene (PTFE) graft s in 25 patients (11 men, 14 women; age range, 29-83 years; mean age, 65.4 years) after pulse-spray pharmacomechanical thrombolysis. Indicat ions for stent deployment included acute angioplasty failure, rapid re stenosis, and vessel perforation. RESULTS: The initial success rate wa s 100%. The mean primary graft patency rates (+/- standard error) at 3 and 6 months were 34% +/- 9 and 27% +/- 9, respectively. Secondary pa tency rates were 77% +/- 8 at 3 months, 72% +/- 9 at 6 months, and 50% +/- 10 at 12 months. Eight of the 26 grafts continued to be used for hemodialysis at the end of follow-up. CONCLUSION: After angioplasty fa ilure or vessel perforation, Wallstent placement at the venous anastom oiss of recanalized PTFE grafts can salvage hemodialysis access functi on. The results Of this study indicate that the 1-year secondary paten cy rate of these grafts is 50%, which approaches the reported rates of patency after balloon dilation as part of percutaneous graft recanali zation.