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Using Pullback Pressure Measurements to Identify Venous Stenoses Persisting After Successful Angioplasty in Failing Hemodialysis Grafts

Brian Funaki1, Richard Kim1, Jonathan Lorenz1, Derek Fimmen1, Thuong Van Ha1, Jeffrey A. Leef1, Jordan D. Rosenblum1, Christopher Straus1 and George X. Zaleski2

1 Department of Radiology, The University of Chicago Hospitals, MC2026, 5841 S. Maryland Ave., Chicago, IL 60637.
2 Racine Radiologist Group, 3803 Spring St., Rm. 208, Racine, WI 53405.



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  		Fig. 1A. —48-year-old woman with left upper arm synthetic dialysis graft referred for angioplasty because of elevated venous pressure. Initial venogram shows significant anastomotic stenosis (arrows) that is partially obscured by adjacent basilic vein.

 


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  		Fig. 1B. —48-year-old woman with left upper arm synthetic dialysis graft referred for angioplasty because of elevated venous pressure. Fluoroscopic image shows balloon angioplasty of anastomotic stenosis.

 


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  		Fig. 1C. —48-year-old woman with left upper arm synthetic dialysis graft referred for angioplasty because of elevated venous pressure. Repeated venogram obtained after angioplasty using 7-mm angioplasty balloon catheter reveals residual stenosis having 10-mm Hg pressure gradient.

 


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  		Fig. 1D. —48-year-old woman with left upper arm synthetic dialysis graft referred for angioplasty because of elevated venous pressure. Repeated venogram obtained after angioplasty using 8-mm angioplasty balloon catheter shows mild residual stenosis having no significant pressure gradient.

 

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