Balloon versus patch angioplasty as an adjuvant treatment to surgical thrombectomy of hemodialysis grafts

BACKGROUND: Transluminal balloon angioplasty offers advantages to patch angioplasty. We evaluated the primary patency of thrombosed hemodialysis grafts that had undergone balloon angioplasty versus patch angioplasty as a salvage method. METHODS: We reviewed our experience with 22 consecutive intraoperative balloon angioplasties that were done in a 6-months period. The balloons used were noncompliant high pressure balloons. The balloon results were compared with those of 22 patients who had undergone patch angioplasties by the same surgeons, Age, gender, average time between graft insertion and revision, and number of prior revisions were analyzed. The two groups (patch and balloon) had similar ages (57 versus 58 years, respectively), gender distribution (12 women, 11 men versus 11 women and 11 men), average time of revisions before that particular procedure (15 versus 12 months), and average times of revisions before that procedure. RESULTS: Primary patencies of the patch and balloon group were respectively 86% versus 77% at 1 month, 45% versus 40% at 3 months, and 17% versus 28% at 6 months. There was no statistically significant difference between the two groups. Complications were comparable in both groups. CONCLUSION: Balloon angioplasty offers advantages to patch angioplasty, and we have shown similar patency rates. We recommend balloon angioplasty as a comparable method to salvage dialysis access grafts. (C) 1997 by Excerpta Medica Inc.