Κατεύθυνση Επεμβατική Ακτινολογία
Library of the School of Health Sciences

2021-04-12

2021

Efthymiou Evgenia

Σταύρος Σπηλιόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ευθυμία Αλεξοπούλου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Φιλιππιάδης, Επικουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Κλινική μελέτη του ρόλου του υπερηχογραφήματος κατά τη διάρκεια της αγγειοπλαστικής δυσλειτουργικών αυτόλογων αρτηριοφλεβωδών επικοινωνιών αιμοκάθαρσης

Greek

Volume flow-guided angioplasty in dysfunctional native arteriovenous fistulas

The purpose of our study is to access the use of sequential intraprocedural volume flow (VF) measurements with transcutaneous Duplex ultrasound (DUS) during balloon angioplasty in dysfunctional native arteriovenous fistulas (AVF), as a new functional endpoint in endovascular treatment. This prospective study, included 20 consecutive patients (23 lesions; 16 men; mean age 67±16 years) with dysfunctional AVF undergoing fluoroscopically guided, balloon angioplasty between 01/06/2019- 01/05/2020. Primary endpoints were procedural success (achievement of a postprocedural VF value ≥ to the baseline steady-state access), quantification of angioplasty outcomes using sequential DUS VF following each dilation and 6-months target lesion re-intervention (TLR)-free rate. Six-month lesion late lumen loss (LLL), correlation of VF values with balloon diameters and QVA measurements were also evaluated.
Results: Procedural success was 80% (16/20 cases). VF-guidance improved procedural success by 20% (4/20 cases) compared to standard assessment (<30% residual stenosis and palpable thrill). Mean VF increase was 168.5%±102.5% (range:24.24%-493.33%). TLR-free rate was 78.3%, 67.3% at 6 and 12 months. Significantly less TLR was noted in cases of procedural success (82.4% vs. 66.7% 6-months;p=0.041). Unweighted linear regression detected significant positive relationship between balloon diameter and VF (146.9±42.3ml/min VF gain per mm of balloon diameter;p=0.001,R2=0.23) and a significant negative relationship between LLL and VF decline at follow-up (102.0±34.6ml/min loss per mm of LLL;p=0.01,R2=0.35). Optimal VF cut off
value and percentile increase to predict reintervention were 720 ml/min (sensitivity 58.3%, specificity 71.4%) and 153% (sensitivity 66.7%, specificity 85.7%); respectively.
In conclusion intraprocedural VF assessment optimized AVF angioplasty and predicted clinical outcomes with reasonable accuracy.

Health Sciences

Volume Flow-assisted balloon angioplasty, Dysfunctional arteriovenous fistula, Intraprocedural transcutaneous Duplex ultrasound

No

0

Yes

106

51

File access is restricted only to the intranet of UoA.

https://pergamos.lib.uoa.gr/uoa/dl/object/2943021