Percutaneous Embolization of Hemodialysis Fistulas by AMPLATZER Vascular Plug with Midterm Follow-up

Abstract

Purpose To determine the midterm technical and clinical results of endovascular occlusion of native hemodialysis fistulas with the use of the AMPLATZER Vascular Plug (AVP) I and AVP II. Materials and Methods Data from 21 patients who underwent endovascular occlusion of their native fistulas between March 2008 and October 2009 were retrospectively evaluated. The reasons for closing the fistulas were hyperdynamic heart failure (n = 2), venous aneurysm with skin ulceration and nipple formation with impending rupture (n = 5), central venous occlusion that could not be recanalized by an endovascular approach (n = 7), dialysis-associated steal syndrome (n = 2), and critical hand ischemia with a nonhealing ulcer or necrosis (n = 5). Results All fistulas were embolized successfully by the end of the intervention. No procedure-related complications were observed after the intervention. The follow-up time ranged from 5 months to 24 months, with a mean of 13.5 months. Conclusions The results of this study suggest that the AVP is a safe and effective device for the endovascular occlusion of hemodialysis fistulas in selected cases.