Scientific Session 19 Hemodialysis: Native Fistula Interventions, Peritoneal Dialysis

of SL Slones was 2. 2.1(1-9). The average average average number number of average ones was 1(1-9). The Slone burden (aggregate (aggregate cross sectional sectional area) area) was was 2.8 2.8 SL one burden cm22 (0.7-6.5). (0.7-6.5). TIle The 20 Fr Fr sheath sheath was advanced over an inincm flaled 66 mm X 10 em cm balloon. balloon. Additional procedures flaLed performed du during the endoscopic stone retrieva retrievall include include performed ring the patients and calycea calyceall diverticu diverticulum eendopyelotomy ndopyelotomy in 33 paLients lum letion of the procedure, a 16 Fr 2. At comp completion fulguration in 2. nephrostomy catheter catheter was was placed placed and usually removed the following day. day. the The patients were followed for a mean of 14.2 months (3-24 momhs). CT scans were obtained immonths). Non-contrast cr mediately follow ing the following the procedures and abdominal radiographs were obtained at 6 month intervals thereafter. RESULTS, RESULTS: Single ~ingle

procedure stone free rate prO
94Y, 94Y. (17118) (17118)

Mean operative time

S4 54 mins

Mean percutan~ous percutaneous tube duration Mean

22 21 hI'hrsS

Mean hospital !lay stay M ean hospit.al

29 hI'hrsS

Maior complications Major

0% 18) OY. (0/ (0118)

Minor complications M inor {omplicalions

!Yo W. (1118)

Mean hematoait M ean decrease in hematocrit

3.4' /a 3.4%

Blood transfusions B lood transfu~ioru

W 0';', (0118) (Oll8)

ReaJrTent calwli calculi RKIlrrent

WI W. (1118) (IIIB)

Recurrent UPJ UP obstruction RKIlrrent

W, (Olll 0/3 oy,

CONCLUSIONS: The Mini-PNL explo exploits CONCLUSIONS· its technologic adpossi ble to remove stones through a vances that make it possible 20 Fr sheath. Reducing the sheath size from 30 Fr to 20 Fr decreases the volume of renal parenchyma ddisrupted isrupted by 56%. The high efficacy of PNL is maintained while bleeding and other co mplications appear to be minicomplications smaller mized. The sma ller nephrostomy nep hrosto my tube can be removed ex peclitiously with resultant decreases in hospita expeditiously hospitall stay.

Single Slngle procedure stone free fre e rate 94% (17/18) (17/ 18) Mean operative lime time 54 mins Mean percutaneous tube duration 22 hrs Mean hospital stay 29 hrs Major complications 0% (0/ 18) Minor complications 6% (1/18) Mean Mea n decrease in (0/18) hematocrit 3.4% Blood transfusions 0% (0/ (0/18) 18) Recurrent / 18) Recurrent UP] obstruction calculi 6% (1 (1/18) obstruCtion (JOA> 0% (0/3) 5:02pm 5,02 pm

Abstract No. 144

Fluoroscopically Guided Retrograde Ureteral Catheterization j.A. Clm'k, Clark, Toronto, Canada • G j. Robinson • fA. R.A. RA . Pugash PURPOSE: To describe our experience with w ith fluoroscoptluo roscopically guided retrograde ureteral catheterization ca theterization as an aid to percutaneous nephrolithotomy. METI-JODS: We attempted retrograde ureteral catheteriMETHODS: za tion in 8 patients (6 women, women , 2 men, aged 29-63 zation percutaneou s nephrolithotomy of a years). In all cases, percutaneous calyceal calyceal calculus reqUired prior prio r percutaneous nephrosne phrostomy. In two cases, antegrade passage of a gUide gu ide wire from fro m the nephrostomy tract beyond the calculus had failed; failed; in the remaining remain ing cases, this this was expected to be

difficult. th ete r for aa 10 of a Foley Foley ca catheter difficult. After After exchange exchange of French sheath , retrograde ureteral catheterization French sheath, retrograde catheterization was attempted with a Cola pinto or Sos Omni with a Colapinto or 50S Omni catheter and and aa hydroph il ic gu ide wire under cystograp hic guidance. hydrophilic guide under cystographic gUidance.

RESULTS· ade ureteral caLheterizaRESULTS:· We We succeeded in retrogr retrograde catheterization tion in all aU 88 patients, patients, allowing allOWing placement of a retrograde retrograde uretera the occluureterall occlusion balloon balloon catheter. catheter. Injection of the sion balloon catheter provided sufficient sufficient retrograde pelvicalyceal distension for successful antegrade passage of aa gUide wire wire from from Lhe the nephrostomy tract beyond the calyceal calculus. All AI! patients subsequent subsequent underwent successful percutaneous nephrolithotomy the operating room. CONCLUSION Fluoroscopically guided retrograde ureteral catheterization is possible possible with a high success rate in our h.i s technique expands the scope small small series of patients. IThis of percutaneous uroradiological intervention. intervention.

Scientific Session 19 Hemodialysis: Native Fistula Interventions, Peritoneal Dialysis Moderators: Scott Scott Savader, MD Lue Luc Turmel-Rodrigues, Turme/-Rodrigues, MD

Wednesday, March 29, 2000 12:30 pm-2:00 pm 12030 12:30 pm

Abstract No. 145

Outcomes of Percutaneous Intervention in Native Arteriovenous Dialysis Fistulae T T. W. W Clark, Halifax, Canada .• R. Abraham •. BX Flemming ·• j. Heelan .• WF WF. Mason BK

Dialys is Outcomes Quality Initiative PURPOSE: The Dialysis (DOQI) guidelines recommend placement of native ar(DOQO teriovenous fistulae over ove r synthetic grafts due to superior patency rates. lim ited data exist to define the rates. However, limited in terventions in failing fistulae. We role of percutaneous interventions repo n primary and secondary patency rates in 52 pareport refen·ed for percutaneous intervention for poorly tients referred func tioning fistulae. fistu lae. functioning na tive arteriovenous fistulae in METHODS: Fifty-three native pe rcu taneous interven tions 52 palients patients underwent 72 percutaneous interventions 21-mondl period. Fistulae Fistu lae were occluded or had over a 21-momh recirculation, reduced total access blood flow, elevated recirculation, press ures or o r difficulty in cannulation ca nnulation elevated venous pressures les ion(s) on on Sig ni fica nt (>50%) lesion(s) with hemodynamically significant fistulograp hy. Most patients patien ts had radial-cephalic radial-ce phalic fistulae fistulography. (n; 28, 53%); the rest had brachial-cephalic (n=l1 (n;l1 , 21%) 210/0) (n=28, o r brachial-basilic (n=14, (n=14, 26%) fistulae. fistulae. Primary and secor interven tion were deterdeterondary patency rates follOWing intervention Kaplan-Me ier method. mined with the Kaplan-Meier

RESULTS: Percutaneous Percu taneous angioplasty angioplasLY was performed of the RESULTS: native artery (n=2), arteriovenous anastomosis (n=12), n=27), distal distal fistula fistu la proximal fistula (beyond anastomosis, n=27), o r central venous venou s stenoses (n=8); stenoses were (n=3) or mu ltiple in 11 patients undergoing u ndergoing angioplasty and all multiple

227

(n=ll).Stents were placed in 7 patients with occlusions (n=l1).Stents central venous stenoses. Immediate technical success was achieved in 66 of 72 interventions (91.7%). Angioplasty failed in 3 attempts and thrombolysis failed in 3 attempts. Thrombolysis was successful in 8 occluded fistulae using urokinase (n=2), t-PA (n=4) or mechanical thrombectomy Primary patency (including technical failures) at 3, 6, and 12 months was 71.4±6.9%, 48.6±8.6910 and 24.3±12.9%. Secondary patency at 3 48.6±8.6% months was 74.3±7.00/o at 6 months. and 74.3±7.001o Failing arteriovenous fistulae are amenable to percutaneous intervention, with mid-term patency rates (including technical failures) comparable to those reported for synthetic dialysis grafts. The high rate of technical failures (8.3%) may be due to highly variable angiographic anatomy of native fistulae fistulae.. CONCLUSION:

12:41 pm

Abstract No. 146

Pen.'Utaneous Management Strategies in Falling Native Arterio-Venous Hemodialysis Fistulae YA1. Dang, Dang, Iowa City, IA • Mj. Sharajuddin Sharafuddin • VAl. CM. Leusner. E.S Dixon • S Sun • KA. Yousef Yousej PURPOSE: Native arterio-venous fistulae (AVFs) have

different patterns of failure compared to synthetic AV access. We reviewed our experience with the approaches/treatment strategies in failing AVFs. MATERIALS AND METHODS: Between January 1998 and

August 1999, 46 patients (29 men, 17 women) underwent a total of 59 percutaneous interventions for failing AVF at our institution. institution. Following initial diagnostic fistulogram, additional access for intervention was obtained: Antegrade access in 57, combined antegrade and retrograde access in 10, and retrograde access alone in 2. PTA of the following segments was performed: inflow artery (1), A-V A-V anastomosis (10), post-inflow or segment-I (37), outflow or segment-II/III (30), and central veins (10). Tandem lesions were present in 14 cases. Occlusions occurred in 8 and were successfully recanalized in 6. Stents (2 central veins, 1 segwere used in 3 patients segments (2 ment-II). Adjunctive lytic therapy, mechanical thrombectomy, Fogarty sweep of anastomotic plug were required in 8 procedures. There were 3 complications, all manpercutaneously. successfully percutaneously.

« 30% residual b risk antegrade t10w, and minimal collaterals) stenosis, brisk was achieved in 52 procedures (88%). Moderate residual stenosis with suboptimal flow persisted in 2 proceual dures. In 5 procedures revascularization could not be completed because of extensive disease or inability to cross an occlusion. Mean access flow (by transonic dilution flow monitor) increased from 412 ± 250 ml/min mllmin to fo llowup was 6.8 ± 1396 ± 839 ml/min (p<.002). Mean followup 4.3 months (range: (range: 1-16 months). Intention-to-treat prima ry/primary-assisted patency rates at I-month, I -month, 3maly/primary-assisted month and 6-months were: 89/89%, 85/89%, and 83/87%, respectively.

RESULTS: Successful technical outcome

228

CONCLU."ION Percutaneous intervention approaches CONCLU."ION: and strategies in failing native AVFs are distinctly different from those in synthetic AV High technical and clinical success and patency rates can be achieved.

12:52 pm

Abstract No. 147

Venous Branch Embolization for Arteriovenous Fistula Salvage Fernandez J.D. Regan, Winston-Salem, NC • SL Fern.andez PURPOSE: To assess the impact of venous branch em-

bolization on radial-cephalic fistula maturation. METllODS: Six consecutive patients MATERIALS AND METlfODS:

with poorly maturing recent (2-8 weeks) radial-cephalic fistulas and one patient with a fistula functioning poorly since its creation 23 months earlier were selected for treatment. Six patients required dialysis with a central venous catheter at the time of treatment. Fistulagrams in all seven patients showed prominent branch veins CAY) anastomosis diwithin 5-6 cm of the arteriovenous (AV) verting flow from the main superficial draining vein, which was flaccid with no palpable flow. Near the AV anastomosis, all patients had a thrill with good venous ~ 50%. All seven padistention and a venous stenosis :2 tients had balloon angioplasty. Branch veins were then ocduded with coils colis delivered through a 4-Fr catheter. occluded Four patients had preprocedure, pre procedure, postangioplasty, and postembolization duplex examinations. Pre- and postprocedure dialysis records were evaluated. RESULTS: Preliminary duplex assessment showed a

mean velocity of 81 em/sec cm/sec in the superficial vein and similar velocities in larger branch veins. After balloon angioplasty, all patients had < 20% residual stenosis but no palpable improvement in flow in the main draining vein. Flow velocities central to the branch unc h anged. After embolization, flow was veins were unchanged.

channeled through a long segment of superficial vein from the wrist to the proximal forearm/antecubetal fossa. A strong thrill was palpable throughout this length in all patients. Mean flow velocity increased to seve n fistulas developed adequately 1.63 m/sec. All seven func tional at for use within 4 weeks; six remained functional 4-18 week follow-up. CONCLUSION Six of seven failing AV fistulas were salCONCLUSION: vaged by embolizing venous branches and redirecting flow through a long segment of superficial vein, resulting in short- and intermediate-term improvement in venous flow and fistu la function. Long-term follow-up fistula with a larger patient population is needed to confirm these promising results.

1:03 pm

Abstract No. 148

Percutaneous Transiumiual Transluminal Angioplasty of Brescia-Cimino Arteriovenous Fistula -Analysis of Factors Adversely Affecting Long-Term Patency K. Sugimoto, Kobe, Japan • S Hirota • T Higashino • Y Kuwata • K. Imanaka • K. Sugimura V

PURPOSE: PURPOSE: To To clarify clarify the the factors factors adversely adversely affecting affecting

inal antong-term long-term patency patency afler after percutaneous percutaneous translum transluminal anhemodialysis Brescia-Ci Brescia-Cimino gioplasty giop lasty (PTA) for hemodialysis mino arterifistulas. ovenous fistu las. MATERIAlS mODS· Between Nnvember MATERiAIS AND AND ME jIIJElliOD5November 1995 1995 and Sep tem ber 1999, September 1999, 68 PTA procedures were were performed oon n 38 patients with 41 Brescia-Cimino fistulas. fistulas. Considering that PTA should be a non-invasive maintenance therapy for for patients with malfunctioning hefistulas, modialysis fistu la s, we analyzed the secondary patency rates with repeated treatment in addition to the results of primary PTAs.Initial technical success rate for all PTAs calculated. and one-year patency rates were calcula ted. Subsequently, primary and secondary one-year patency rates were compared by using the Kaplan-Meier method between two patient groups. They were classified on the basis of several factors, including age (elder, over 70 yea rs and younger group), with or without diabetes melyears litus (DM), solilary solitary or multiple lesions, long or short segment lesion (1SL (LSL or SSL), stenosis or occluSion, occlusion, and with or without withollt arterial and/or and!or anastomotic lesions (AL).

RESULTS: Sixty-one of the 68 procedures (90%) were imRESUL7S: mediately successful and 39 of the 41 shunts (95%) were maintained by primary PTA. Primary and secondary oneyear patency rates were 300/0 30% and 47% respectively. As for the primary patency, the comparative study showed that the ratios were 27% for the elder and 33% for the younger group, 38% for the patients with DM and 23% solitary lesion and 17% 170/0 for mulfor the others, 48% for a solilary tiple leSions, lesions, 43% for occlusions and 18% for stenoses, 32% for LSL and 25% for SSL, and 26% for AI. Ai and 33% for others. As for the secondary patency, it showed that the ratios were 36% for the elder and 57% for the younger group, 41% for the patients with DM and 36% for the othleSions, ers, 51% for a solitary lesion and 45% for multiple lesions, 500/0 for SSL, SS1., 56% for occlusions and 39% 49% for LSS and 50% 39010 for stenoses, and 45% for AL and 48% for others. No statistica l significance Significance was found for any of these factors. tistical

Forty-four Forry-four % % were were diabetic. diabetic. AVF AVF type type was radial-cephalic radial-cephalic in in 39%, 390AJ, and brachial-cephalic brachial-cephalic in in 61%. 61%. Eighty-four Eighty-four % % of of fistulae had lysis. Causes had been been used used successfully successfully for for dia dialysis. Causes for for referral induded included abnormal hemodynamiC hemodynamic parameters on nce (dimin.ished on routine routine access sUiveilla sUlveillance (diminished transonic acreCirculation, cess flow rate, high flow recirculation, elevated venous venous prespressures, or abnormal duplex duplex sonography) sonography) in 52%, insufficie nt hemodialysis, failure of of AVF AVF to to mature, hand cient ischemia, arm swelling, and inability to access the fisUlIa. fistula.

RESULTS: Distinct angiogra phic patterns were recognized angiographic in aa failing AVF. Competing tflow Competing outflow (multiple ou outflow veins w ithout a dominant outflow channeD without channel) occurred in 112%. ZOAl. Undeveloped! Atretic ou tflow was encountered in Undeveloped!Atretic outflow 4%. Bulbar dilatation immediately adjacent to the AV-anastomosis occurred in 59%. Pseudoaneurysmlaneurysmal Pseudoaneurysm/aneurysmal degeneration of the fistula occurred OCCUlTed in 180/0. 18%. Occlusive disease was far more common than thrombotic tluumbotic disease disease,, with severa severall recognizable patterns of involvement. Inflow (feeding artery): 2%, A-V anastomotic: 17%, Segment-l Segment-I artery); ZOAl, (post-anastomoticJpost-bulbar) (post-anastomotic/post-bulbar); 51%, segment-II (forearm outflow vein} (arm outflow vein): 26%, vein): 16%, segment-Ill (ann and segment-IV (central ve ins) 15%. Muhi-segment veins): Multi-segment stenoses OCCUlTed in 2()}i1. 20%. Segmenlal Segmental occlusion OCCUlTed in 12%. 'Thrombus lhrombus usually usuaUy occurred OCCUlTed in association with large aneurysm. In non-aneurysmal AVFs, thrombosis was typicaUy limited to an arterial anastomotic plug) ly plug, usuaJ usually with an underlying critical stenosis of segmenl-I. segment-I. CONCLUSION CONCLUSION: Disease patterns in native AVF are distinct from synthetic AY AV grafts. 111is This has important implications on plann ing and performance of percutaneous perCUlaneous planning interventions. intelventions.

1:25 pm

Abstract No. 150

A New Screening and Management Protocol to Increase the Number of Functioning Renal Dialysis Arteriovenous Fistulae Teodorescll .}. • j. Uribam A. Falk, New York, NY. V Teodorescu Uriburri • H. Lautin • F Moore J-J. Milly. Milty • j. £aulin

se ries. We conteriorate in relation to any factor in our series. clude that the indication for PTA should shou ld be Widened. widened.

PURPOSE: To increase the ratio of renal dialysis arteriovenous fistulae fistul ae (AYF) arteriove nous grafts (AVF) versus arteriovenous (AYG) through a preoperative screening screen ing and post operope r(AVG) surve illance and treatment protocol. pro[Qcol. ative sUlveillance

1:14 1<14 pm

MATERIALS AND ME7HODS: ME7710DS. 123 patients with end e nd

CONCLUSIONS: The long-term patency rate did not nol de-

Abstract No. 149

Patterns of Failure in Native Arterio-Venous Artcrio-Venous Hemodialysis Fistulae j. Sharajuddin Shara/uddin • YM. Dang, Iowa City, L4 • M J. CM. Leusner • B.A. Dixon· Dixon. S. Sun. Sun . K. f( Yousej Youse! CJI1. PURPOSE: Recent DOQI recommendations call for inal1erio-venous fistulae CAVFs), (AVFs), creased number of native arterio-venous preViously an uncommon type of hemodialysis access previously in the rhe USA. We reviewed our ou r cumulative cu mulative experience to study the pattern of failure of AVFs.

MATERIALS AND MElHODS: MEIHODS· Between February 1998 and MATERiALS

August 1999, 49 patients undelwent underwent diagnostic diagnostiC fistulofistulo" instinleva luation of a failing AVF at our institugrams for the evaluation rion. There were 30 men and 19 women, mean age 52. tion.

undenvent upper extremity color rena l disease undelwent stage renal eva luate the suitability of their doppler ultrasound to evaluate AYF. 63 AVF AYF and 15 AVG AYG were veins to support an AVF. placed. 55 patients are currently awaiting access placement. AVF that failed to mature (21/63) after 3 months were evaluated by follow up color doppler ultrasound and referred for appropriate intervention. RESULTS.. Of tile tl,e 21 AVF that failed to mature 16 had RESULTS: proxima l stenoses (2 with additional cephalic vein focal proXimal ste noses and 1 with an upper arm cephalic venous ocstenoses stenosis, clusion), 1 had an upper arm cephalic venous stenosis, 1 had a central venous stenosis, 1 was thrombosed, and 1 was patent. All stenoses were treated with PTA. The thrombolYSis and PTA. occluded AVF was treated with thrombolysis

229

21 lesions were treated with wilh percuta neous In 19 patients 21 percutaneous intervention. All 21 percutaneous interventions were tec.lmically 12/ 19 treated AVF are teclmically successful. Currently, 12/19 19 are awa iting being used for hemodialysis access. 4/ 4/19 awaiting maturation, 3/19 have occluded, and 2/19 2/ 19 are patent, but have not manned. matured. One complication occurred, dissection of a cephalic vein, vein, w hich was treated with addiwhich FoUow uup p was 2-18 2- 18 months, with a mean of tional PTA. Follow 8 months. months. 3 patients died during the follow up period, 1] d ied before access placement. with a working AVF and 2 died in itial 63 AVF placed, 5/63 5/ 63 were converted to Of the initial AVG and 6/63 were converted to tunnelled tunne lled catheters. CONCLUSIONS: The number of more desirable AVF versus AVG can be increased by preoperative screening. ca n be successfully treated with AVF that fail to mature can intelvention. Venous stenoses in these papercutaneous intervention. angiop lasty so that AVF function fu nction can tients respond ro to angioplasty be establis hed or restored. restored. established

1036 pm 1:36 pm

Abs tract No. 151 Abstract

Safety aand nd Efficacy of of Tenckhoff cathete Catheterr Manipulation CA . Bonawitz, Chapel Hill, Hill, NC· NC • IS. CA. ].S. Sandhu ·• PF Jaques ·• S.M. Weeks •. MA. M.A . Mauro PFjaques

per· PURPOSE: To determine the safety and efficacy of permanipu lation of malma lcutaneous fluoroscopically guided manipulation functioning peritoneal dialysis d ialysis catheters. MATERIALS AND METHODS: A retrospective analysis

encompassing 9 years and 59 patients was performed of ca theter seventy nine Tenckhoff studies obtained due to catheter (poor/ non-funct ion: n= 57, pa in/discomdysfunction (poor/non-function: pain/discommalpoS ition: n= 5, not specified: n= 9). Mafort: n= 6 , malposition: ni pulation was performed using a malleable steerable nipulation ion steel cannula . Contrast injection without manipulat manipulation Technical success, patency rates was performed 5 times. Technical tions were recorded. reco rded. and complica complications lnitial technical tech nica l success resulting in adequate RESULTS: Initial catheter func tion and position was achieved in 91% function 9010 (n=7). (n=67). Manipulation failure was observed in 9% Only contrast injection was performed in 5 instances with revealed appropriate position and function in 3, catheter tip located in the transverse colon in one and extensive kinking of the catheter ca theter with the tip located in sma ll cavity which did not corrununicate a small communicate with the perianolher. Ten patients were lost to fo llow up. follow toneum in another. calheter manipulaPrimary patency rates (from time of catheter tion)had a bimodal distribution and ranged from 2-133Od 2-]330d (mean:=244d, rates, (mea n=244d , median=135d). median=]35d). Secondary patency rates, J- 950d (mean=300d, (mean~300d, meme· also bimodal, bimodal, ranged from 1-950d dian=86d). Factors predisposing to manipulation and fail ures were: sub-optimal surgical long term patency failures ]5% (n=9) and ca theter length 15% placement or excessive catheter peritoneal adhesions 19% (n=] (n=I1). 1). One patient developed with in 1 month of the manipulation. peritonitis within

230

CONCLUSJON CONCLUSION: Fluoroscopically guided Tenckhoff mao manipulat ion and COnlrast ion is safe and efe fnipulation contrast evaluat evaluation

ficac ious in preserving catheter function thereby proficacious longing peritoneal dialysis.

1:47 pm

Abs tract No. No . 152 Abstract

Percutaneous Radiologic RadiolOgic Placement of Continuou Continuouss Pe rito n eal Dia lysis Catheters Ambulatory Peritoneal Dialysis S}. Savader, Savadet; Indianapolis, IN.].F IN · IF. Geschwind • Sj. G.B . Lund ·• Pj. Pj. Scheel G.B.

eva lua te the efficacy of percutaneous raPURPOSE: To evaluate nt of continuous conti n uous ambulatory ambu latory periddiologic iologic placeme placement toneal dialysis (CAPD) (CAPO) catheters. MA7ERlALS AND MEmODS: METHODS: Nineteen end-stage renal MATERiALS

female , n=8) with a mean disease patients (male, n=11; n=11; female, 38--85 years) underwent percuage of 58 years (range, 38-85 taneous placement of a corrunercially commercially available CAPD catheter. All procedures were performed utilizing conoul-patient basis. Patients Patie nts scious sedation and on an out-patient techn ical success, complications, were followed for technical ca theter survival, and long-term long-te rm outcome. catheter REWJLTS: The technical success rate for catheter placeRE'lULTS:

ment was 95% (18/19). (18/19). Complications included one (5%) fa iled case of procedure related peritonitis and one (5%) failed procedure. procedure. Mean and median catheter survival was 320 and 289 days, respectively (range. 33-{323 days). A Ka(range, 33-823 plan-Meier survival analysis yielded a 6, 12, ]2, and 24 liry of catheter survival surviva l of .89, .81, month probabi probability .8], and .81, respectively. Long-term outcomes included: continued respectively. CAPO CAPD with same catheter originally placed, 0;9 n=9 (47%); n~6 (32%) (all deaths secondary to co-morbid a)·morb id dis· death, n=6 disease) ; successful renal transplant, n:;:;:2 (10.5%); transplant, n=2 00.5%); and re(10.5%). mained on or converted to hemodialysis, n=2, 00.5%). CONCLUSION Percutaneous radiologic placement of CONCLUSION: CAPO CAPD catheters has a high technica technicall success rate, a low incidence of procedure related complications, and can be performed pe rformed on an oout-patient m-patie nt basis. Catheter survival is comparable to tha ically placed thatt seen in surg surgically catheter series.

Scientific Session 20 Stents/Brachytherapy Moderators: Dieter Liermann, Liermann, MD Moderators: Martin, MD Louis G. Martin,

Wednesday, March 29, 2000 12:30 pm-2:00 pm 12dOpm 12:30 pm

Abs trac t No. 153 Abstract

Comparlsion in the State of o f lumina Comparision Lumina Afte Afterr Expe rime n tal Placem ent ooff Bare and Covered Covere d Experimental Placement of Blood Bloo d Vessels Z-Stent in Various Types of Y Osaka, Japan T Kaminou • M. M . Isota Isola ·• Y. Sakai, Osaka, japan .• T. X. Tong .• K. Nakamura •. R. Yamada PURPOSE: Although several studies on stenosis after placement of stent have been performed performed,, reports of simultaneous examination of aneries, arteries, veins and portal