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Bare Metal Stent Patency in Dysfunctional Hemodialysis Vascular Access
- Author(s)
- 이경민
- Advisor
- 원제환
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2022-02
- Language
- eng
- Keyword
- AVF; BMS; Bare metal stent; Nitinol stent; Stent; vascular access
- Alternative Abstract
- Purpose: To evaluate the patency of nitinol bare-metal stent (BMS) according to the location of stent placement in patients with dysfunctional hemodialysis vascular access. Materials and methods: Between January 2017 and December 2019, 159 patients (95 male, 64 female; mean age, 64.1 ±13.2 years) underwent nitinol BMS placement for dysfunctional vascular access. Total 103 native arteriovenous fistula (AVF) and 56 arteriovenous graft (AVG) patients were included. Subgroup analysis according to the location of stent placement was assessed. The location of stent placement was as follows; brachiocephalic vein (n=18), cephalic arch (n=51), venous limb (n=40), juxta-anastomotic vein (n=10), arteriovenous anastomosis (n=7), and graft-vein (GV) anastomosis (n=33). Postintervention primary and secondary patency at 12 months was evaluated by Kaplan-Meier method, log-rank test, and Cox regression model. Results: Total 159 stents were successfully deployed in 103 native arteriovenous fistulas (AVF) and 56 arteriovenous grafts (AVG). AVG showed significant poor patency in primary and secondary patency at 12-month compared with AVF (primary patency; 25.0% vs 44.7%, respectively, hazard ratio [HR], 1.78; P = .005, secondary patency; 76.8% vs 92.2%, respectively, hazard ratio [HR], 3.04; P = .014). Cox regression model shows that cephalic arch (n=51) and GV anastomosis (n=33) had lower postintervention primary patency at 12-month compared with other site in total group of AVF and AVG. There was no significant difference of secondary patency according to the stent location in patients with AVF and AVG. Conclusion: AVF showed better patency rate in primary and secondary patency at 12-month compared with AVG. Stent placement for cephalic arch or GV anastomosis was increased risk of poor primary patency at 12-month.
- Fulltext
- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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