Abstract: FR-PO577
A Successful Ultrasound-Guided Percutaneous Transluminal Angioplasty for a Patient with Arteriovenous Graft Failure Within 24 Hours of Its Creation and After 3 Months Since Failure
Session Information
- Dialysis and Vascular Trainee Case Reports
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Report
- 704 Dialysis: Vascular Access
Authors
- Guan, Tianjun, Zhongshan Hospital, Xiamen University, Xiamen, China
- Chen, Anqun, Zhongshan Hospital, Xiamen University, Xiamen, China
- Ziming, Wan, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Introduction
The primary purpose of any hemodialysis access is to provide adequate, long-term and repeated access to the circulatory system with minimum complications.Arteriovenous graft (AVG) rarely fails acutely within the postoperative period causing graft loss with the need for subsequent creation of new hemodialysis access. We describe the rescue of the AVG which immediately failed following its creation, there was no hope for its future use, so consequently was abandoned for over three months.
Case Description
The 63 years old woman with end stage renal disease has been on chronic hemodialysis since 2014.Her right distal arteriovenous fistula was functional until November 2018 when it failed. The right elbow brachial-basilic graft was created successfully which also failed within 24 hours following its creation.3 months later after creation, this patient was referred to our centre.Ultrasonography visualized stenosis at the peripheral draining vein, severe stenosis at venous-graft anastomosis and intragraft stenosis with no flow of blood through the entire graft. Ultrasound guided Percutaneous transluminal angioplasty was performed with immediate restoration of good graft patency, good patency of brachial artery and basilic vein. The next day, patient used the AVG for hemodialysis successfully for the first time .The AVG remained patent and chronically usable for hemodialysis up to 4 months.
Discussion
Our case demonstrates the feasibility of repairing an immediately failed arteriovenous dialysis graft following its creation with restoration of good patency adequate for chronic hemodialysis by ultrasound guided percutaneous transluminal angioplasty, even after 3 months since failure.