supera for the juxta-anastomotic avf stenosis...supera for the juxta-anastomotic avf stenosis...
TRANSCRIPT
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Supera for the Juxta-anastomotic AVF Stenosis
Technical Tips and Tricks
Dr Shannon D. ThomasVascular Access SurgeonConjoint Senior Lecturer
University of New South WalesSydney, Australia
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Disclosure
Speaker name:
Dr S. D. Thomas.......................................................................
I have the following potential conflicts of interest to report:
x Consulting: Abbott Vascular
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interest
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JXAS stenosis can lead to loss of the AVF
JXAS stenosis frequency ranging from 43% 2 to 100%5 of all AVFs
If severe, can cause the AVF to remain small and immature
Can lead to problematic dialysis
Can cause thrombosis of the AVF and eventual loss
2. Falk et al. Treatment of ”swing point stenoses” in hemodialysis arteriovenous fistulae. Clinical Nephrology.
2003;60:35-41
5. Sivanesan S, How TV, Bakran A. Sites of stenosis in AV fistulae for haemodialysis access. Nephrology,
dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European
Renal Association 1999;14:118-20.
18. Clark TW, Cohen RA, Kwak A, et al. Salvage of nonmaturing native fistulas by using angioplasty.
Radiology 2007;242:286-92.
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JXAS Primary Patency: 92.5% at 6 months, 59.8% at 12 months
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JXAS Assisted Primary Patency 97.5% at 6 months, 92.9% at 12
months
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JXAS Assisted Primary Patency 97.5% at 6 months, 92.9% at 12
months
JXAS Endovascular Re-Intervention rate .31/year
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Supera can be used to change the anastomotic Shape
Pre-Stent JXAS Stenosis Post-Stent Supera JXAS
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• Puncture mid forearm useable segment
• Ber2 and V18 wire to cross into radial inflow artery (Can be difficult)
• Predilatation is a mandatory
• Elongate stent in radial artery to deploy stent to radial artery diameter
• Pack stent through anastomosis and swing vein segment
Technical Tips
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Deploy the stent to the radial artery diameter
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Conclusion
JXAS Supera deployment can be challenging
Patency benefit to patient is pay off
Alllows for long term maintanence of an AVF
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Thank you
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Supera for the Juxta-anastomotic AVF Stenosis
Technical Tips and Tricks
Dr Shannon D. ThomasVascular Access SurgeonConjoint Senior Lecturer
University of New South WalesSydney, Australia