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Objective:To analyze the effect of percutaneous transluminal angioplasty (PTA) in the treatment of autogenous arteriovenous fistula (AVF) stenosis and influcing factors of restenosis/loss of function after PTA.Methods:The medical records of 104 patients with AVF stenosis treated by PTA in People′s Hospital of Huadu District from March 2019 to July 2020 and the 1-year follow-up were retrospectively analyzed. Kaplan-meier curves were used to analyze the primary patency rates at 3 months, 6 months and 1 year. COX regression was used to analyze the influencing factors of restenosis/loss of function after PTA.Results:The primary patency rates of AVF at 3, 6 and 12 months after PTA were 86.2%, 83.2% and 64.7%, respectively. Guide wire entry into the distal end of radial artery, the use of two balloons in stepwise mode, postoperative dilatation diameter, and dialysis blood flow after PTA were independent risk factors for restenosis/loss of fuction after PTA for AVF stenosis (all P<0.05). Conclusions:The guide wire into the distal end of the artery and passive use of more than two balloons are important factors affecting AVF restenosis/loss of function after PTA .
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Objective To investigate the patency rate and restenosis after percutaneous transluminal angioplasty (PTA) for the treatment of arteriovenous fistula (AVF) and arteriovenous graft (AVG) stenosis in dialysis patients. Methods The patients who were successfully treated by PTA for the first time in the blood purification center of the 2nd Affiliated Hospital of Nanjing Medical University from January 2016 to June 2017, including 71 cases of AVF in the forearm, 52 cases of AVF in the upper arm and 59 cases of AVG were recorded. The data of different stenosis parts were analyzed before and after treatment and followed up for 12 months. The initial patency rate and assisted-PTA patency rate were observed at 3 months, 6 months, 9 months, and 12 months after ultrasound interventional therapy, and the initial patency time for patients who needed to reintervention among all types of pathways were recorded. Results The initial patency rates at 3 months, 6 months, 9 months and 12 months after ultrasound interventional therapy were 98.59％, 90.14％, 71.93％, 54.93％ respectively in forearm AVF, 90.38％, 65.38％, 42.31％, 32.69％ respectively in upper arm AVF, 91.53％, 32.20％, 6.78％, 1.69％ respectively in AVG, and the PTA-assisted patency rates were 98.59％, 97.18％, 95.77％, 94.37％ respectively in forearm AVF, 92.31％, 86.54％, 84.62％, 80.77％respectively in upper arm AVF, 100.00％, 98.31％, 96.61％, 93.22％ respectively in AVG, while the initial patency time was (8.99 ± 3.54) months in forearm AVF, (6.33 ± 3.01) months in upper arm AVF, (4.80 ± 1.40) months in AVG respectively. Conclusions Ultrasound can comprehensively evaluate the function of peripheral vascular access, guide PTA treatment, and evaluate treatment outcomes. Ultrasound intervention therapy has best initial patency rate for forearm AVF stenosis. The prognosis of upper arm AVF stenosis PTA is relatively poor due to the easy cephalic stenosis. Although AVG has a short interval of restenosis, it can achieve a better long-term patency rate through regular intervention with ultrasound intervention.
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Objective To explore the curative effect of percutaneous balloon dilation in treatment of arteriovenous internal fistula stenosis in hemodialysis patients.Methods 1 9 patients with arteriovenous fistula stenosis were treated by the expansion of balloon angioplasty.Changes of the fistula tremor and postoperative dialysis flow,and vascular stenosis degree on angiography and color doppler ultrasound were compared between pre-and post-treatment in order to evaluate the curative effect.Results The treatments of balloon dilation in all patients were successful without any intraoperative and postoperative complications.Intraoperative angiogra-phy showed an improvement of the arteriovenous fistula stenosis with a decrease by 20%.After treatment,the fistula tremor and di-alysis flow were significantly increased,which met the need of the hemodialysis.Conclusion The treatment of arteriovenous fistula stenosis with percutaneous balloon dilatation is safe,effective,noninvasive and simple.