Abstract: FR-PO533
Drug-Eluting Stents in Treating Arteriovenous Graft Thrombosis: A Pilot Study
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Boktor, Ivana, George Walton Comprehensive High School, Marietta, Georgia, United States
- Ali, Ahmed E., Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
- Albalas, Alian, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Almehmi, Ammar, The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background
Thrombosis of the arteriovenous graft (AVG) related to venous anastomosis stenosis is associated with poor access survival in dialysis population. The use of standard and drug-coated balloons and covered stents is associated with poor primary access patency. On the hand, drug-eluting stents (DES) have been used successfully in coronary and peripheral interventions with low reintervention rates. Hence, this study sought to explore the effect of DES in treating AVG thrombosis and subsequent overall access patency.
Methods
This is a retrospective study that included a total of 9 patients receiving dialysis via AVGs who presented with thrombosis and underwent DES deployment during the thrombectomy procedure. Patient demographics and post-intervention follow-up data were extracted from the vascular database. Primary endpoints included graft primary patency, procedural success, and complication rates.
Results
The cohort included 4 men and 5 women with a median age of 55 years (ranging from 22 to 81 years). Common comorbidities included hypertension 100% (9/9), diabetes mellitus 67% (6/9), and hyperlipidemia 44% (4/9). The main indication for DES deployment was recurrent thrombosis of an existing AVG. After the procedure, all the patients were prescribed dual antiplatelet therapy for one month. All stents were deployed successfully and no immediate complications were encountered. The target lesion for DES placement was the venous-graft anastomosis. The median follow-up period was 421 days (IQR: 78). Results showed a significant improvement in graft patency rates, with a target lesion primary patency rate of 55.5%. During the follow-up, 5 patients required no interventions, the other 4 patients continued to suffer from access thrombosis requiring a new dialysis access placement.
Conclusion
The findings of this case series underscore the potential role of DES in managing AVG thrombosis related to venous anastomosis stenosis. Moreover, while this study is hypothesis-generating in nature, it invites further investigation to understand the complex pathophysiology of dialysis access lesions.