IF11. Stent Graft vs Balloon Angioplasty for Treatment of Hemodialysis Prosthetic Graft Outlet Stenosis: A Prospective Randomized Study

Abstract

Hemodialysis graft outlet stenosis is the most common problem for hemodialysis patients using prosthetic grafts as their vascular access. Currently, balloon angioplasty remains the first-line endovascular treatment for those lesions. However, covered graft implantation seems to be an effective and promising solution. A prospective and randomized study was conducted in a section of vascular surgery of a tertiary medical center in which 98 patients with dialysis grafts with symptomatic outlet stenosis were randomized into two groups: 49 stent graft group patients and 49 balloon angioplasty group patients. After intervention, 3 months, and 6 months, a survey with angiography was done for those patent grafts to compare the rate of angiographic restenosis of the two groups. In addition, the primary patency of two groups was carefully followed, calculated, and analyzed. The postintervention restenosis rate of the stent graft group was obviously better than the balloon group, at 9% vs 69% at 3 months and 29% vs 72% at 6 months. The primary patency rates of stent graft vs balloon groups at 3 months, 6 months, and 12 months were 91.7%, 83.2%, and 46.9% vs 65.3%, 27.8%, and 7.8%. The mean primary patency after treatment was 380.22 ± 28.54 days for the stent graft group and 151.08 ± 16.79 days for balloon group. Stent graft provides a better solution over plain balloon angioplasty on hemodialysis graft outlet stenosis treatment, with a lower postintervention restenosis rate and longer primary patency.