Abstract No. 393 Use of Covered Stents for the Treatment of the Dysfunctional Vascular Access. A Single-Center Retrospective Analysis of 356 Patients and 621 Procedures

To evaluate the safety and effectiveness of the use of covered stents for the treatment of the dysfunctional vascular access. From July 2006 to December 2022 (16.5 years), 356 patients (65.4 years) with 373 vascular accesses (VA) [72 arteriovenous fistulas (AVFs) and 301 arteriovenous grafts (AVG), age: 2.43 years] underwent 621 procedures with covered stent placement. 258 VA were placed in the left arm and 334 VA in the upper arm. All types of treatments areas and lesion types were included. Primary outcome measures were target lesion primary patency (TLPP) and access circuit survival (ACS), defined as the time between treatment and vascular access thrombosis, surgical intervention, or abandonment. Subgroup analysis on different treatment areas and factors was also performed to identify potential independent predictors that could influence the primary outcome measures. Mean follow-up was 1.55 years. TLPP was 60.7%, 38.9% and 21.2% at 6, 12, and 24 months. There was no significant difference between AVFs and AVGs in median TLPP (203 vs 271; p=0.85). ACS was 69.6%, 53% and 34% at 6, 12 and 24 months. There was no significant difference in median ACS between AVFs and AVGs (352 vs 404; p=0.38)and in TLPP (p=0.098) between de novo and restenotic lesions. De novo lesions had better TLPP and ACS compared to restenotic ones (303 vs 216; p=0.068) and (p=0.009) respectively. The infection rate was 2.7% (10/373 accesses). In this retrospective analysis covered stents provided results comparable to the literature regarding both TLPP and ACS. Further subgroup analysis findings will also be presented.