BALLOON VERSUS PATCH ANGIOPLASTY AS AN ADJUVANT TREATMENT TO SURGICALTHROMBECTOMY OF HEMODIALYSIS GRAFTS

BACKGROUND: Transluminal balloon angioplasty offers advantages to patc h angioplasty. We evaluated the primary patency of thrombosed hemodial ysis grafts that had undergone balloon angioplasty versus patch angiop lasty as a salvage method. METHODS: We reviewed our experience with 22 consecutive intraoperative balloon angioplasties that were done in a 6-months period. The balloons used were noncompliant high pressure bal loons. The balloon results were compared with those of 22 patients who had undergone patch angioplasties by the same surgeons, Age, gender, average time between graft insertion and revision, and number of prior revisions were analyzed. The two groups (patch and balloon) had simil ar ages (57 versus 58 years, respectively), gender distribution (12 wo men, 11 men versus 11 women and 11 men), average time of revisions bef ore that particular procedure (15 versus 12 months), and average times of revisions before that procedure. RESULTS: Primary patencies of the patch and balloon group were respectively 86% versus 77% at 1 month, 45% versus 40% at 3 months, and 17% versus 28% at 6 months. There was no statistically significant difference between the two groups. Compli cations were comparable in both groups. CONCLUSION: Balloon angioplast y offers advantages to patch angioplasty, and we have shown similar pa tency rates. We recommend balloon angioplasty as a comparable method t o salvage dialysis access grafts. (C) 1997 by Excerpta Medica Inc.