gms | German Medical Science

Background: To compare the technical success, primary patency of thrombosed prosthetic vascular access grafts of the upper limb after thrombectomy and dealing with the stenosis at the venous anastomotic site either with percutaneous angioplasty (PTA) with a Paclitaxel coated balloon or with stenting using a covered stent.

Methods: we reviewed the data of forty-seven (47) patients with thrombosed prosthetic vascular access PTFE grafts of the upper limb, who met our inclusion criteria from January 2014 till January 2021, patients underwent thrombectomy and intraoperative angiography. Patients were stratified into two groups according to how we dealt with venous anastomotic site. In group A, we used a Paclitaxel coated balloon, while in group B we used a covered stent.

Results: The success rate was 100% (n=26), 100% (n=21) in both groups, in either the technical aspect or the clinical one (having dialysis from the access). There was no statistically significant difference between both groups as regard the descriptive data. Also, there was no statistical difference between both groups as regard the time since creation of the access (P = 0.9159). The primary patency of the procedure for group A at 3, 6, 12, 18, and 24 months was 88.46%, 73.08%, 61.54%, 53.85%, and 42.31% respectively, while in group B it was 90.48%, 80.95%, 66.67%, 57.14%, and 52.38% respectively.

Conclusion: Using covered stent has a higher patency rate than using Paclitaxel-coated PTA balloon catheters for treating venous site anastomotic stenosis especially in midterm follow up periods, but still these results are statistically insignificant may be due to small number of study sample.