Análisis de la punción de prótesis intravasculares recubiertas tras el rescate de la fístula arteriovenosa después de 12 meses de experiencia

Abstract

Patients and method: Twenty patients, with VIABAHN(r) implanted, were studied for pseudoaneurysms with thrombosis, ulcers in the puncture sites, failure of angioplasty or restenosis in less than 6 months. Parameters of AVF, primary and secondary patency (6 and 12 months), presence of complications and control of prosthesis deterioration by phlebography at 3 and 6 months were studied. For the puncture, a period of 4 weeks was expected. Results: A period of 15 ± 9.4 months was analyzed. The mean of the functional parameters of the AVF during hemodialysis was: blood flow rate: 362.5 ± 43.3 ml / min, Arterial Pressure: -209.5 ± 35.6 mmHg, Venous Pressure: 215.8 ± 34.5 mmHg, Kt 55 ± 5.4 l and recirculation 12.7 ± 3.7%. At 6 months, 66% (95% CI: 54-77) of the patients had primary permeability and 77% (95% CI 67-87) had secondary permeability. At 12 months 38% (IC 95% 24-52) primary permeability and 76% (IC 95% 66-87) secondary permeability. No adverse events related to the puncture, nor radiologically objectified deterioration in prostheses were observed. There was an episode of infection requiring removal of the prosthesis. Conclusión: The VIABAHN(r) coated vascular prosthesis is effective and safe in the rescue of stented and / or thrombosed native AVFs, as it provides excellent dialysis parameters and high primary and secondary permeability, without repeated puncture associated with complications.