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Kidney Week

Abstract: FR-PO497

Outcome of Central Venoplasty and AVFistuloplasty in a Tertiary Care Centre in Eastern India

Session Information

  • Dialysis: Vascular Access
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 803 Dialysis: Vascular Access

Authors

  • Sadhukhan, Sourav, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
  • Pal, Atanu, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
  • Datta, Aniruddha, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
Background

Access crisis is the Achilles heel of dialysis in ESRD patients. Central vein stenosis and stenosis in mature AVfistulas are common and negatively impact the quality of hemodialysis. Here we report the outcome of central venoplasty and fistuloplasty in our centre.

Methods

This was an retrospective observational study. Study period january21 to april22. Minimum follow up was 6 months.
Central venoplasty was preceded with venography. Right/left common femoral, internal jugular/venous limb of fistula were used as access, followed by gradual balloon dilatation and stent placement if required.
For fistuloplasty, arterial/venous limb was used as access, followed by balloon dilatation.

Results

Total 38 primary and 5 secondary venoplasty performed.
42.1% patients had tunneled catheter,52.6% had AVF and 5.3% had temporary catheter.73.7%patients had access failure,26.3%- upper limb swelling.73.7% had CRBSI episodes>3. Mean duration to develop CVS-34.5m(SD-13.6m).
32(84.2%) were successful and 15.8% failed.Restenosis developed in 7(18.4%).Mean duration to develop restenosis-105.3d(SD-53.6d).
21 patients undergone Fistuloplasty. Mean patency of AVF -1.03Yr. perianastomotic stenosis -71.4% outflow stenosis -19.04%, inflow stenosis-9.52%.
Fistuloplasty was successful in 85.7% cases. Mean fistula flow volume-110.47ml/min(SD-79ml/min)(pre) 438ml/min(SD-244.9 ml/min)(post).
4 cases developed restenosis.
complications-minor bleeding-6 cases, venous rupture in 2 and brachial artery pseudoaneurysm in 1 case.

Conclusion

This outcome analysis suggests that central venoplasty and fistuloplasty have very good outcome in the management of access issues in ESRD patients, but cost and restenosis are the main limiting factors.

Types of AVF
radiocephalicbrachiocephalicbrachiobasilic
57.14%28.57%14.28%