Transluminal laser recanalization for stenoses of failed HD access

Stenoses in venous limbs of failed HD access were recanalized by Nd-YAG laser in three clinical cases. In the two initial cases, a 2mm round glass hot tip was used as a laser probe tip. One of the stenoses was occluded at five months after laser treatment because of insufficient luminal recanalization. In the last case, newly constructed 3mm and 4mm round glass hot tips were used to gain further enlargement of the recanalized lumen. Intraoperative fistulogram, electromagnetic flowmetry measuring mean flow volume, and vascular endoscopy demonstrated that laser recanalization with this new type of hot tip is beneficial for creating a large lumen. Transluminal operative laser recanalization was useful for repair of stenoses of venous limbs of HD access because of the short operation time, small surgical incision, and maintenance of a venous limb for puncture after operation.