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Hemodialysis-related Venous Stenosis: Treatment with Ultrahigh-Pressure Angioplasty Balloons¹

¹ From the Department of Radiology, Division of Interventional Radiology and Medicine (S.O.T., S.W.S., R.S.G., C.M.T.) and Division of Nephrology (S.K., M.R.R.), University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St, Philadelphia, PA 19104. Received June 17, 2003; revision requested August 29; revision received September 2; accepted September 4. Address correspondence to S.O.T. (e-mail: streroto@uphs.upenn.edu).

The authors retrospectively reviewed the use of ultrahigh-pressure angioplasty balloons at atmospheric pressures at or above the manufacturer recommended burst pressure (30 atm) for the treatment of resistant hemodialysis-related venous stenosis at their institution. In seven of 87 procedures, high-pressure angioplasty (up to 27 atm) was unsuccessful. By coupling new balloon technology with aggressive inflation pressures, 100% technical success was achieved in the treatment of stenoses that were resistant to high-pressure angioplasty in these seven procedures. This approach could potentially offer cost savings compared with the costs of other previously described treatment methods for resistant lesions, such as atherectomy devices and cutting balloons.

© RSNA, 2004

Index terms: Dialysis, 81.42, 9_*.457², 9_*.458 • Veins, transluminal angioplasty, 9_*.454, 9_*.458

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