Endovaskulární léčba arteriovenozních pištělí pro hemodialýzu

Endovascular treatment of arteriovenous fistula for dialysis Aim: Aim of presented retrospective study was to evaluate the primary patency of angioplasty using a drug eluting balloon (DEB) and conventional balloon (PTA) in dysfunctional dialysis fistula. Methods: 58 adult patients treated for fistula dysfunction in the period from 2015 to 2018 were enrolled based on following criteria - matured native fistula with stenosis above 50 % compared to the adjacent healthy vein. Patients with restenosis, swing point, cephalic arch, and central vein stenosis, and multiple distant stenoses were ruled out. Patients were divided into two groups according to received treatment - DEB and PTA. Primary patency of angioplasty was defined as the function of dialysis without the need for clinically driven endovascular or surgical intervention on culprit lesion during follow-up. Secondary, dialysis access patency, 12-month assisted patency, technical, clinical success, complication rate, and mortality among treated groups were evaluated. Results: Primary patency at 6 and 12 months follow up was evaluated in 25 patients in the DEB and 25 patients in the PTA group. Primary lesion and access patency were in DEB vs. PTA: 96 % vs. 76 % (p = 0,1) and 96 % vs. 72 % (p = 0,049) at 6 months, 80 % vs. 56 % (p = 0,13), 80 % vs....Endovaskulární léčba arteriovenozních pištělí pro hemodialýzu Cieľ práce: Cieľom prezentovanej retrospektívnej práce bolo zhodnotiť a porovnať primárnu priechodnosť angioplastiky pomocou paclitaxelom potiahnutého (DEB) a štandardného balónika (PTA) v liečbe stenózy zlyhávajúcej dialyzačnej fistuly. Metodika: Zo súboru pacientov liečených pre dysfunkciu dialyzačnej fistuly v rokoch 2015 - 2018 splnilo inklúzne kritériá 58 dospelých pacientov s maturovanou natívnou fistulou so stenózou viac ako 50 % v porovnaní s priľahlou zdravou vénou. Exklúzne kritériá boli restenóza, stenóza v "swing point oblastiach", v oblasti centrálnych vén a viacpočetné vzdialené stenózy. Primárne bola hodnotená priechodnosť angioplastiky definovaná ako funkčnosť dialýzy bez potreby endovaskulárnej alebo chirurgickej intervencie na príčinnej lézii v ročnom sledovaní. Sekundárne ciele boli determinované ako priechodnosť dialyzačného prístupu, ročná asistovaná priechodnosť, technický a klinický úspech procedúry, miera periprocedurálnych komplikácií a mortalita v jednotlivých skupinách. Štatistická významnosť bola stanovená na hladine p = 0,05. Výsledky: Primárna priechodnosť bola v 6. a 12. mesiaci hodnotená u 25 pacientov v skupine DEB a 25 v skupine PTA. Primárna priechodnosť lézie a priechodnosť dialyzačného prístupu bola -...Department of Diagnostic RadiologyRadiologická klinikaFaculty of Medicine in Hradec KrálovéLékařská fakulta v Hradci Králov

Endovascular Treatment of Arteriovenous Fistula for Dialysis

Endovascular treatment of arteriovenous fistula for dialysis Aim: Aim of presented retrospective study was to evaluate the primary patency of angioplasty using a drug eluting balloon (DEB) and conventional balloon (PTA) in dysfunctional dialysis fistula. Methods: 58 adult patients treated for fistula dysfunction in the period from 2015 to 2018 were enrolled based on following criteria - matured native fistula with stenosis above 50 % compared to the adjacent healthy vein. Patients with restenosis, swing point, cephalic arch, and central vein stenosis, and multiple distant stenoses were ruled out. Patients were divided into two groups according to received treatment - DEB and PTA. Primary patency of angioplasty was defined as the function of dialysis without the need for clinically driven endovascular or surgical intervention on culprit lesion during follow-up. Secondary, dialysis access patency, 12-month assisted patency, technical, clinical success, complication rate, and mortality among treated groups were evaluated. Results: Primary patency at 6 and 12 months follow up was evaluated in 25 patients in the DEB and 25 patients in the PTA group. Primary lesion and access patency were in DEB vs. PTA: 96 % vs. 76 % (p = 0,1) and 96 % vs. 72 % (p = 0,049) at 6 months, 80 % vs. 56 % (p = 0,13), 80 % vs...

Endovascular Treatment of Gastrointestinal Hemorrhage

Background and Objectives: Severe non-variceal gastrointestinal bleeding is a life-threatening condition with complicated treatment if endoscopic therapy fails. In such cases, transcatheter arterial embolization is recommended. The technical and clinical effects of this technique were analyzed in this group of patients, as well as its complication rate and 30-day mortality. Materials and Methods: Patient data over a one-decade period (from 2010 to 2019) were analyzed retrospectively; 27 patients (18 men and 9 women; median age 61 years) treated by endovascular embolization in our institution, with clinically significant gastrointestinal hemorrhage after unsuccessful or impossible endoscopic treatment, were identified, and their data were collected. Results: The source of bleeding was found in 88% of patients, but embolization was performed in 96% of them. The overall technical success rate was 96.8%, and the clinical success was 88.5%. Re-bleeding occurred in eight cases, five of whom had re-embolization that was technically successful in four cases. The incidence of re-bleeding was significantly higher in patients with two or more comorbidities (p = 0.043). There was one serious complication (4%) in the group, and minor difficulties occurred in 18% of patients; 30-day mortality reached 22%. Mortality was significantly higher in the group of patients with re-bleeding (p = 0.044). Conclusions: Transcatheter arterial embolization is a mini-invasive method with high technical success in patients with endoscopically untreatable gastrointestinal bleeding; it is also suitable for high-risk cases. Mortality (to a significant extent) depends on the occurrence of re-bleeding and the patient’s comorbidities

Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial

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