PTA failures of AV graft lesions

Percutaneous transluminal angioplasty (PTA) has significant limitations when treating Arteriovenous (AV) access lesions1

  • Patency rates diminish with each successive angioplasty procedure1,2
    • In the REVISE Clinical Study, patients undergoing PTA who had a previous intervention at the target lesion had lower primary patency at 6 months when compared with patients with no prior interventions at the target lesion (29.2% vs. 43.9%)1 
  • The 2019 KDOQI guidelines for vascular access specify a target goal of ≤ three interventions annually to maintain access3
    • In support of achieving this goal, KDOQI recommends stent grafts in preference to angioplasty alone for recurrent clinically significant stenotic AV access lesions
angiogram

Before

Thrombosed left arm AV graft.  80% stenosis just past venous anastomosis.

Images courtesy of Jason Burgess, M.D. Used with permission.

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angiogram

After

Post-placement of 7 mm x 5 cm GORE® VIABAHN® Endoprosthesis

Images courtesy of Jason Burgess, M.D. Used with permission.

Read the full case study

The GORE® VIABAHN® Endoprosthesis with PROPATEN Bioactive Surface*,† has proven patency independent of the number of prior interventions1

Proven patency

  • Provided consistent patency independent of the number of times a lesion has previously been treated1 
Six month target lesion chart

FEWER REINTERVENTIONS

  • Reduced the average number of reinterventions by 27% over two years within the circuit compared to PTA4

Stent graft design provides unique benefits to the treatment of lesions refractory to PTA

  • Expanded PTFE (ePTFE) flow lumen covers and seals off diseased tissue

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* As used by Gore, PROPATEN Bioactive Surface refers to Gore’s proprietary CBAS Heparin Surface.

† Also referred to as the GORE® VIABAHN® Endoprosthesis with Heparin Bioactive Surface in some regions.

  1. Vesely T, DaVanzo W, Behrend T, Dwyer A, Aruny J. Balloon angioplasty versus Viabahn stent graft for treatment of failing or thrombosed prosthetic hemodialysis grafts. Journal of Vascular Surgery 2016;64(5):1400-1410.e1. http://www.sciencedirect.com/science/article/pii/S0741521416301756
  2. Kanterman RY, Vesely TM, Pilgram TK, Guy BW, Windus DW, Picus D. Dialysis access grafts: anatomic location of venous stenosis and results of angioplasty. Radiology 1995;195(1):135-139.
  3. Lok CE, Huber TS, Lee T, et al; KDOQI Vascular Access Guideline Work Group. KDOQI Clinical Practice Guideline for Vascular Access: 2019 update. American Journal of Kidney Diseases 2020;75(4)Supplement 2:S1-S164.
  4. Mohr BA, Sheen AL, Roy-Chaudhury P, Schultz SR, Aruny JE; REVISE Investigators.  Clinical and economic benefits of stent grafts in dysfunctional and thrombosed hemodialysis access graft circuits in the REVISE Randomized Trial.  Journal of Vascular & Interventional Radiology 2019;30(2):203-211.e4.

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