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Stent graft deployment in haemodialysis fistula: Patency rates in partially thrombosed aneurysm and residual thrombi

Clinical Kidney Journal Feb 19, 2020

García-Medina J, et al. - Since the existing evidence is inadequate to ascertain the contribution of stent grafts as a treatment in partially thrombosed aneurysms or residual wall-adherent thrombi in arteriovenous fistulae (AVFs) for haemodialysis, researchers undertook this retrospective analysis to examine patency rates of post-interventional covered stent deployment in those cases. They evaluated whether patency rates varied when fistulas were punctured by the stent during dialysis sessions. This analysis included 27 procedures. Following stent deployment, primary patency rates (%) estimated at 3, 6, 12, 24, 36 and 72 months were, respectively: total 59, 32, 32, 21, 11 and 5; stent puncture 53, 21, 21, 16, 5 and 0; and no stent puncture 80, 80, 80, 40, 40 and 40. Findings are suggestive of the likely feasibility of stent graft treatment in partially thrombosed aneurysms and residual thrombi in AVF. Although fistulas punctured via the stent exhibited lower patency rates, no higher risk of obstruction related to this practice was observed. Further inquiries to verify or deny the benefits of this procedure are required, giving the impossibility of comparing with similar approaches.
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