2024 ARRS ANNUAL MEETING - ABSTRACTS

RETURN TO ABSTRACT LISTING


4684. Endovascular Management of Pediatric Dialysis Access: A Retrospective Study
Authors * Denotes Presenting Author
  1. Jake DiFatta *; The University of Alabama at Birmingham Heersink School of Medicine
  2. Chase Mahler; The University of Alabama at Birmingham Heersink School of Medicine
  3. Priyanka Mitta; The University of Alabama at Birmingham Heersink School of Medicine
  4. Junjian Huang; The University of Alabama at Birmingham
  5. Andrew Gunn; The University of Alabama at Birmingham
  6. Rachel Oser; The University of Alabama at Birmingham
  7. Junaid Raja; The University of Alabama at Birmingham
Objective:
This study aims to investigate whether pharmaco-mechanical intervention can be safe and effective in the maintenance of pediatric dialysis access fistulas and grafts.

Materials and Methods:
A retrospective analysis of 75 interventions performed on 17 pediatric patients with dialysis access-maintenance interventions was conducted. Frequency of use of angioplasty, stenting, advanced techniques (e.g., rotational thrombolysis devices), and thrombolytic agents, such as tissue plasminogen activator (tPA), were recorded across interventions. Total number of interventions per patient and time between reinterventions were measured. The safety, technical success, and clinical success of these therapies was then assessed according to the SIR complication guidelines.

Results:
The application of pharmaco-mechanical intervention demonstrated a favorable safety profile and high success rates across all categories. Notably, no major complications were observed during or after the procedures. Among the 75 interventions, angioplasty was the most frequently employed technique (<em>n</em> = 63, 84.0%), followed by thrombolysis (<em>n</em> = 32, 42.7%), advanced therapies (<em>n</em> = 13, 17.3%), and stenting (<em>n</em> = 10, 13.3%).

Conclusion:
The use of endovascular techniques for dialysis access maintenance in pediatric patients including angioplasty, stenting, thrombolysis, and advances therapies can be safely and effectively performed. Notably, no major complications were reported in any of the 75 interventions performed on 17 patients, primary technical success was achieved in 97.3% (73/75), and average time to reintervention was 135 days for the 15 patients who received more than one treatment.