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International Journal of Nephrology
Volume 2011 (2011), Article ID 464735, 6 pages
http://dx.doi.org/10.4061/2011/464735
Clinical Study

Efficacy of SMART Stent Placement for Salvage Angioplasty in Hemodialysis Patients with Recurrent Vascular Access Stenosis

1Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
2Department of Radiological Technology, Oyokyo Kidney Research Institute, Hirosaki 036-8243, Japan
3Department of Urology, Oyokyo Kidney Research Institute, Hirosaki 036-8243, Japan
4Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan

Received 5 August 2011; Revised 2 October 2011; Accepted 5 October 2011

Academic Editor: Alejandro Martín-Malo

Copyright © 2011 Shingo Hatakeyama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Vascular access stenosis is a major complication in hemodialysis patients. We prospectively observed 50 patients in whom 50 nitinol shape-memory alloy-recoverable technology (SMART) stents were used as salvage therapy for recurrent peripheral venous stenosis. Twenty-five stents each were deployed in native arteriovenous fistula (AVF) and synthetic arteriovenous polyurethane graft (AVG) cases. Vascular access patency rates were calculated by Kaplan-Meier analysis. The primary patency rates in AVF versus AVG at 3, 6, and 12 months were 80.3% versus 75.6%, 64.9% versus 28.3%, and 32.3% versus 18.9%, respectively. The secondary patency rates in AVF versus AVG at 3, 6, and 12 months were 88.5% versus 75.5%, 82.6% versus 61.8%, and 74.4% versus 61.8%, respectively. Although there were no statistically significant difference in patency between AVF and AVG, AVG showed poor tendency in primary and secondary patency. The usefulness of SMART stents was limited in a short period of time in hemodialysis patients with recurrent vascular access stenosis.