Abstract
The incidence of arteriosclerotic obliterans (ASO) has rapidly increased in hemodialysis (HD) patients because a greater number of diabetic and elderly patients have received HD therapy. In addition, arteriosclerotic disease has become an important complication in younger patients receiving long-term HD. The present study was designed to evaluate the effectiveness of interventional treatment in HD patients with ASO.
PTA was performed in 25 HD patients (including 19 diabetic and 6 non-deabetic patients) with a total of 50 arteriosclerotic lesions (>Fontaine Grade II). Eleven lesions were located in the illiac artery (IA), 26 in the femoropopliteal artery (FPA) and 13 in arteries below the knee (BK). The restenotic rate was evaluated more than 3 months after PTA by angiography.
A total of 43 lesions (86.0%) in 22 patients, including 11 lesions (100%) in IA, 22 lesions (84.6%) in FPA and 10 lesions (76.9%) in BK, showed improvement of stenosis immediately after PTA. Improvement of clinical symptoms was observed in 19 patients (86.9%) after PTA. However, restenosis (narrowing>50%) occurred in 26 patients (60.5%). Restenosis was more frequent in diabetics (23/37, 63.9%) than in non-diabetics (3/7, 42.9%). In diabetic patients, the restenosic rate was significantly higher in BK (8/8, 100%) than in IA (5/11, 45.5%) and FPA (10/17, 58.8%).
We concluded that PTA is useful for ASO in HD patients, and that further development of technical devices are needed to prevent restenosis in diabetic patients, especially that of peripheral arteries.
