Endovascular stent placement for angioplasty-induced venous rupture related to the treatment of hemodialysis grafts

PURPOSE: To assess the use of endovascular stents for treating rupture afte r percutaneous transluminal angioplasty (PTA) in the maintenance of hemodia lysis grafts. MATERIALS AND METHODS: From February 1, 1994, to August 1, 1997, 683 hemodi alysis-related angioplasty procedures were performed on 277 patients to tre at thrombosed or poorly functioning polytetrafluoroethylene (PTFE) hemodial ysis bridge grafts. In each of these procedures, angioplasty of the venous anastomosis or the outflow vein was performed. This study is a retrospectiv e review to analyze uncovered endovascular stents placed to treat ruptures after PTA. RESULTS: Fourteen ruptures were treated with use of an uncovered metal sten t, Stent placement was technically successful in II of 14 patients, with cl inical success in 11 of 14 cases, The primary patencies at 30, 60, 90, and 120 days were calculated by means of Kaplan-Meier life-table analysis; thes e were 63%, 54%, 46%, and 46%, respectively. The secondary patencies at 60, 120, and 180 days were 85%, 75%, and 75%, respectively. No complications w ere attributable to stent placement, The results are comparable to those of stents placed for reasons other than rupture, and support the efficacy of their use for this indication. CONCLUSION: Endovascular stent placement is a safe and effective means of s alvaging angioplasty-induced rupture that occur's during the treatment of h emodialysis grafts.