Angioplasty of communicating veins to the brachial vein in haemodialysis patients with obliterated superficial veins of the upper arm

Abstract

AIM: To evaluate the outcomes of angioplasty of the communicating veins when

superficial veins of the upper arm were almost totally obliterated in

haemodialysis patients. MATERIALS AND METHODS: Twenty-one angioplasties of the

communicating veins that were performed for failing haemodialysis fistulas in

patients with almost totally obliterated superficial veins of the upper arm from

December 2006 to March 2011 were retrospectively reviewed. Fistulas were of the

following types: native radiocephalic fistulas (n = 20) and radio-antecubital

fistulas (n = 1). All angioplasties were performed using 5-8 mm conventional

balloons. Cutting balloon angioplasty was additionally performed in five

patients. The primary, secondary, and target lesion patency rate was calculated

using Kaplan-Meier analysis. RESULTS: The communicating vein was located in the

antecubital fossa. Technical and clinical success rates were 100% and 95.2%,

respectively. Follow-up duration was 1-52 months (mean 20 months). The primary

patency rates were 76%, 43%, and 29% at 3, 6, and 12 months, respectively, and

target lesion patency rates were 81%, 62%, and 43% at 3, 6, and 12 months,

respectively. The secondary patency rates were 81%, 76%, and 57% at 3, 6, and 12

months, respectively. There were no major or minor complications. CONCLUSION:

Angioplasty of the communicating vein is effective in restoring function in

failing haemodialysis fistula in patients with obliterated superficial veins of

the upper arm.