drug-eluting stent for the treatment of early fistula failure药物洗脱支架治疗瘘早期的失败.pdfVIP

International Journal of Clinical Medicine, 2011, 2, 196-200 doi:10.4236/ijcm.2011.23032 Published Online July 2011 (http://www.SciRP.org/journal/ijcm) Drug-Eluting Stent for the Treatment of Early Fistula Failure Luigi di Serafino, Laura Scudiero, Mario de Laurentis, Federica Ilardi, Fabio Magliulo, Giuseppe Carotenuto, Cinzia Perrino, Giovanni Esposito Division of Cardiology, Federico II University, Naples, Italy. Email: espogiov@unina.it Received November 26th st th , 2010; revised February 1 , 2011; accepted February 10 , 2011. ABSTRACT Introduction : Morbidity and mortality in chronic haemodialysis patients is related to dialysis efficiency. Several com- plications may occur with vascular access usually associated with a stenosis. This is known to occur frequently in the venous outflow. Stenosis of the arterial side is not as frequently discussed, but it is also likely to compromise fistula function. Traditionally , surgical and percutaneous interventions have been used to treat failing fistulas, but the em- ployment of drug-eluting stents for the treatment of failing fistulas due to the arterial stenosis has been described rarely. Methods : A 65-year-old male patient referred to our ambulatory because of hand ischemia during haemodialysis treatments only few days after radial-cephalic fistula creation. After physical and echo-color-doppler examination, an- giography was performed and percutaneous intervention was proposed. After the positioning of a guiding catheter, the lesion was crossed with a 0.014” guide wire followed by direct drug-eluting stent implantation. Results : Final an- giogram showed a good result and a preserved flow through the fistula. Six months later the patient was asymptomatic and the fistula was still wor