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Sharp Needle Recanalization Technique for Peripheral Hemodialysis Arteriovenous Fistula Occlusion

  • Technical Note
  • VENOUS INTERVENTIONS
  • Published:
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Abstract

Purpose

To determine the efficacy of a percutaneous sharp needle recanalization technique for the treatment of peripheral hemodialysis arteriovenous fistula (AVF) occlusion.

Materials and Methods

This study included 13 patients (14 procedures) between May 2010 and February 2020 with non-thrombotic AVF occlusion wherein guidewire passage through the occluded segment had failed. We successfully passed the guidewire through the occluded segment using a sharp needle recanalization technique with Chiba or Colapinto needles, under ultrasound or fluoroscopic guidance. The type of AVF, site and length of occlusion, technical success, complications, and long-term patency were analyzed.

Results

Technical success was achieved in 12 (85.7%) out of 14 procedures. The procedure failed in two patients due to the poor angle of approach in the axillary area and diffuse severe stenosis in the draining cephalic vein. In eight procedures, sharp needle recanalization was performed under ultrasound guidance, while the other six procedures were performed under fluoroscopic guidance. Chiba and Colapinto needles were used in five and nine procedures, respectively. The mean length of occlusion was 2.7 cm (range 1.8–4.2 cm). There was one case of mild complication, that is, mild contrast extravasation, which was treated by stent deployment. The post-intervention primary patency rates at 6 months, 1 year, and 2 years were 81.8%, 36.4%, and 18.2%, respectively.

Conclusion

The results of this limited series suggest that the sharp needle recanalization technique is a simple and effective method for the treatment of peripheral non-thrombotic AVF occlusion.

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References

  1. Kim HK, Kwon TW, Cho YP, et al. Outcomes of salvage procedures for occluded autogenous radiocephalic arteriovenous fistula. Ther Apher Dial. 2011;15(5):448–53.

    Article  Google Scholar 

  2. Brescia MJ, Cimino JE, Appel K, et al. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med. 1966;275(20):1089–92.

    Article  CAS  Google Scholar 

  3. Ryan JJ, Dennis MJ. Radiocephalic fistula in vascular access. Br J Surg. 1990;77(12):1321–2.

    Article  CAS  Google Scholar 

  4. Schwab SJ, Harrington JT, Singh A, et al. Vascular access for hemodialysis. Kidney Int. 1999;55(5):2078–90.

    Article  CAS  Google Scholar 

  5. Beathard GA, Eradat J. Chronically occluded arteriovenous fistula salvaged by sharp needle recanalization. Semin Dial. 2015;28(6):E58-63.

    Article  Google Scholar 

  6. Wu CC, Lin MC, Pu SY, et al. Comparison of cutting balloon versus high-pressure balloon angioplasty for resistant venous stenoses of native hemodialysis fistulas. J Vasc Interv Radiol. 2008;19(6):877–83.

    Article  Google Scholar 

  7. Tessitore N, Mansueto G, Lipari G, et al. Endovascular versus surgical preemptive repair of forearm arteriovenous fistula juxta-anastomotic stenosis: analysis of data collected prospectively from 1999 to 2004. Clin J Am Soc Nephrol. 2006;1(3):448–54.

    Article  Google Scholar 

  8. Anil G, Taneja M. Revascularization of an occluded brachiocephalic vein using Outback-LTD re-entry catheter. J Vasc Surg. 2010;52(4):1038–40.

    Article  Google Scholar 

  9. Arabi M, Ahmed I, Mat’hami A, et al. Sharp central venous recanalization in hemodialysis patients: a single-institution experience. Cardiovasc Intervent Radiol. 2016;39(6):927–34.

    Article  Google Scholar 

  10. Goo DE, Kim YJ, Choi DL, et al. Use of a rosch-uchida needle for recanalization of refractory dialysis-related central vein occlusion. AJR Am J Roentgenol. 2010;194(5):1352–6.

    Article  Google Scholar 

  11. Guimaraes M, Schonholz C, Hannegan C, et al. Radiofrequency wire for the recanalization of central vein occlusions that have failed conventional endovascular techniques. J Vasc Interv Radiol. 2012;23(8):1016–21.

    Article  Google Scholar 

  12. Honnef D, Wingen M, Gunther RW, et al. Sharp central venous recanalization by means of a TIPS needle. Cardiovasc Intervent Radiol. 2005;28(5):673–6.

    Article  Google Scholar 

  13. Iafrati M, Maloney S, Halin N. Radiofrequency thermal wire is a useful adjunct to treat chronic central venous occlusions. J Vasc Surg. 2012;55(2):603–6.

    Article  Google Scholar 

  14. Majdalany BS, Monfore N, Khaja MS, et al. Radiofrequency wire recanalization of chronically occluded venous stents: a retrospective, single-center experience in 15 patients. Cardiovasc Intervent Radiol. 2019;42(1):130–6.

    Article  Google Scholar 

  15. Malik AK, Bhalla N, Goel A, et al. Percutaneous reconstruction of chronic total occlusion of brachiocephalic vein using transseptal needle in dialysis-dependent patient. Cardiovasc Interv Ther. 2016;31(2):136–9.

    Article  Google Scholar 

  16. Chen MC, Weng MJ. The pipeline technique: a simple endovascular technique for creation of a jump graft bypass. J Vasc Access. 2016;17(1):93–7.

    Article  CAS  Google Scholar 

  17. Heller SL, Clark TW. Percutaneous creation of a venous anastomosis in a native hemodialysis fistula. J Vasc Interv Radiol. 2009;20(10):1371–5.

    Article  Google Scholar 

  18. Kuo MD, Son DH, Miller FJ. Salvage of a failing dialysis graft by percutaneous creation of a jump bypass graft. J Vasc Interv Radiol. 2007;18(8):1054–8.

    Article  Google Scholar 

  19. Miller GA, Koh E, Khariton A, et al. Sharp needle recanalization for salvaging hemodialysis accesses with chronically occluded peripheral outflow. J Vasc Access. 2012;13(1):22–8.

    Article  Google Scholar 

  20. Timpone VM, Gover DD. Percutaneous creation of a jump bypass graft in a native arteriovenous hemodialysis fistula. J Vasc Interv Radiol. 2011;22(5):734–6.

    Article  Google Scholar 

  21. Gray RJ, Sacks D, Martin LG, et al. Reporting standards for percutaneous interventions in dialysis access. J Vasc Interv Radiol. 2003;14(9):S433-442.

    Article  Google Scholar 

  22. Khalilzadeh O, Baerlocher MO, Shyn PB, et al. Proposal of a new adverse event classification by the society of interventional radiology standards of practice committee. J Vasc Interv Radiol. 2017;28(10):1432-37.e1433.

    Article  Google Scholar 

  23. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603–10.

    Article  Google Scholar 

  24. Tessitore N, Mansueto G, Bedogna V, et al. A prospective controlled trial on effect of percutaneous transluminal angioplasty on functioning arteriovenous fistulae survival. J Am Soc Nephrol. 2003;14(6):1623–7.

    Article  Google Scholar 

  25. Turmel-Rodrigues L, Pengloan J, Baudin S, et al. Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology. Nephrol Dial Transplant. 2000;15(12):2029–36.

    Article  CAS  Google Scholar 

  26. Chen MC, Wang YC, Weng MJ. Percutaneous creation of bare intervascular tunnels for salvage of thrombosed hemodialysis fistulas without recanalizable outflow. Cardiovasc Intervent Radiol. 2015;38(4):894–902.

    Article  Google Scholar 

  27. Yan Wee IJ, Yap HY, Hsien Ts’ung LT, et al. A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis. J Vasc Surg. 2019;70(3):970–9.

    Article  Google Scholar 

  28. Cao Z, Li J, Zhang T, et al. Comparative effectiveness of drug-coated balloon vs balloon angioplasty for the treatment of arteriovenous fistula stenosis: a meta-analysis. J Endovasc Ther. 2020;27(2):266–75.

    Article  Google Scholar 

  29. Rokoszak V, Syed MH, Salata K, et al. A systematic review and meta-analysis of plain versus drug-eluting balloon angioplasty in the treatment of juxta-anastomotic hemodialysis arteriovenous fistula stenosis. J Vasc Surg. 2020;71(3):1046–54.

    Article  Google Scholar 

  30. Yuan Y, Cheng W, Lu H. Drug-eluting balloon versus plain balloon angioplasty for the treatment of failing hemodialysis access: a systematic review and meta-analysis. Ann Vasc Surg. 2020;64:389–96.

    Article  Google Scholar 

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Funding

This study was not supported by any funding.

Author information

Authors and Affiliations

  1. Department of Radiology, Kyung Hee University Medical Center, Seoul, Korea

    Seung Yeon Noh

  2. Department of Radiology, Soon Chun Hyang University Hospital, 59 Daesagwan-Ro, Yongsan-gu, Seoul, 04401, Korea

    Dong Erk Goo & Yong Jae Kim

  3. Department of Radiology, Soon Chun Hyang University Hospital, Gumi, Korea

    Seung Boo Yang

  4. Department of Radiology, Soon Chun Hyang University Hospital, Bucheon, Korea

    Jae Myeong Lee

  5. Department of Radiology, Soon Chun Hyang University Hospital, Cheonan, Korea

    Woong Hee Lee

Authors
  1. Seung Yeon Noh
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  2. Dong Erk Goo
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  3. Yong Jae Kim
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  4. Seung Boo Yang
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  5. Jae Myeong Lee
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Corresponding author

Correspondence to Dong Erk Goo.

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For this type of study, formal consent is not required. This study was reviewed and approved by the Soon Chun Hyang University Seoul Hospital Institutional Review Board.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Noh, S.Y., Goo, D.E., Kim, Y.J. et al. Sharp Needle Recanalization Technique for Peripheral Hemodialysis Arteriovenous Fistula Occlusion. Cardiovasc Intervent Radiol 44, 1809–1816 (2021). https://doi.org/10.1007/s00270-021-02809-1

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  • DOI: https://doi.org/10.1007/s00270-021-02809-1

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