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2017 ; 7
(2
): 63-72
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gab.com Text
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English Wikipedia
Hemodialysis Arteriovenous Access Occlusion Using the Amplatzer Vascular Plug in
Patients with Intractable Arm Edema
#MMPMID28868296
Filippo MD
; Barbarisi D
; Ferrara D
; Brancaccio S
; Del Guercio L
; Bracale R
; Capuano A
; Esposito G
; Bracale UM
Case Rep Nephrol Dial
2017[May]; 7
(2
): 63-72
PMID28868296
show ga
OBJECTIVES: Vascular occlusion of hemodialysis arteriovenous access (AVA) using
an Amplatzer vascular plug (AVP; St. Jude Medical, St. Paul, MN, USA) is an
arising and alternative practice in selected patients; however, few reported
cases can be found in the literature. Herein, we report on our experience with
endovascular treatment of complicated AVA. MATERIALS AND METHODS: From September
2015 to December 2016, 3 patients at our clinic underwent an occlusion of
hemodialysis AVA with 2 different Amplatzer vascular plugs: 2 patients with type
II and 1 patient with type IV. Of these, 1 patient was treated for an autologous
radiocephalic fistula, the second patient was treated for an autologous
brachiocephalic fistula located at the elbow, and the third was, instead, treated
for a radiocephalic forearm fistula. The reason for closing the AVA in all
patients was due to the presence of dialysis-associated steal syndrome with
critical hand ischemia and intractable ipsilateral edema. RESULTS: All AVAs were
treated using an AVP. No plug migration, access revascularization, persistent
ischemia, nor other complications were observed. CONCLUSION: This report suggests
that the use of AVP for embolization of complicated AVA is a safe and reasonable
alternative to open surgery in selected patients.