Hemodialysis access angioplasty: Office-based duplex-guided dialysis found safe

Office-based duplex-guided dialysis found safe
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2010 Vascular Annual Meeting

Duplex-guided dialysis can be safely performed in an office environment, according to study data presented at the 2010 Vascular Annual Meeting in Boston.

From January 2008 through June 2009, one vascular surgeon performed 223 office-based duplex guided hemodialysis access angioplasty procedures in 125 patients.

Researchers performed the procedures in the office using both topical and local anesthesia. Volume flow was recorded prior to introducer insertion and following the intervention. Two hundred and eight of the treated accesses were fistula; maturation angioplasty was performed in 115 cases; and maintenance angioplasty was completed in 108 cases. Stents were also placed in five cases.

Technical success was achieved in 219 cases (98.2%). Complications occurred in 19 cases (8.5%), including two introducer site hematomas, four introducer site pseudoaneurysms, eight thrombus developments, three angioplasty site ruptures and two angioplasty site pseudoaneurysms.

“The most common indication for intervention was for maturation failure which had occurred in 104 cases,” explained David Fox, MD, a vascular surgeon at Lenox Hill Hospital in New York City, in a press release. “Other indications included pulsatility in 29 cases, low access flow in 28 cases, decreased flow in 23 cases and infiltration in 13 cases.”

According to researchers, technical advantages of office-based duplex guided hemodialysis access angioplasty include real time visualization in puncture sites, stenoses, thrombus, spasm and extravascular flow.

“Of course further advantages include a strong patient and physician preference for the convenience and efficiency of the office environment as compared to the hospital, and in this setting there are also potential financial advantages for the practitioner,” added Fox.

For more information:

* Fox D. Abstract SS11. Presented at: 2010 Vascualr Annual Meeting; June 10-13, 2010; Boston.

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