Long-Term Efficacy of Ultrasound-Guided Percutaneous Transluminal Angioplasty for Arteriovenous Fistula Outflow Stenosis Caused by Venous Valve

作者全名：Chen, Bo; Chen, Ling; Yang, Qiao; Gao, Xuejing; Lai, Qiquan; Tu, Bo; Wan, Ziming

作者地址：[Chen, Bo; Tu, Bo] Chongqing Med Univ, Dept Ultrasonog, Affiliated Hosp 1, Chongqing, Peoples R China; [Chen, Ling; Gao, Xuejing; Lai, Qiquan; Wan, Ziming] Chongqing Med Univ, Dept Nephrol, Affiliated Hosp 1, Chongqing, Peoples R China; [Yang, Qiao] 941th Hosp PLA Joint Logist Support Force, Dept Ultrasonog, Xining, Peoples R China

通信作者：Wan, ZM (通讯作者)，Chongqing Med Univ, Dept Nephrol, Affiliated Hosp 1, Chongqing, Peoples R China.

来源：KIDNEY DISEASES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001205116000001

JCR分区：Q1

影响因子：3.2

年份：2024

卷号：10

期号：2

开始页：89

结束页：96

文献类型：Article

关键词：Venous valve-related stenosis; Percutaneous transluminal angioplasty; Arteriovenous fistula; End-stage renal disease; Primary patency

摘要：Introduction: Venous valve-related stenosis (VVRS) is an uncommon type of failure of arteriovenous fistula among patients with end-stage renal disease (ESRD). There is a paucity of data on the long-term efficacy of ultrasound-guided percutaneous transluminal angioplasty (PTA) for VVRS. Methods: ESRD patients who underwent PTA because of VVRS between January 2017 and December 2021 at the First Affiliated Hospital of Chongqing Medical University were enrolled. Patients were classified into three cohorts (cohort1, VVRS located within 3 cm of the vein adjacent to the anastomosis; cohort2, VVRS located over 3 cm away from the anastomosis; cohort3, multiple stenoses). The patency rates were assessed by the Kaplan-Meier method and compared using the log-rank test. Univariate and multivariate Cox analyses were performed to identify the risk factors. Results: A total of 292 patients were enrolled, including 125 (42.8%), 111 (38.0%), and 56 (19.2%) patients in cohort1, cohort2, and cohort3, respectively. The median follow-up was 34.8 months. The 6-month, 1-year, 2-year, and 3-year primary patency rates were 86.0%, 69.4%, 47.5%, and 35.3%, respectively. The secondary patency rates were 94.5%, 89.4%, 75.5%, and 65.3%, respectively. Cohort1 showed a relatively better primary patency compared to cohort2 and cohort3. The secondary patency rates were comparable in the three cohorts. Duration of dialysis and VVRS type were potential factors associated with primary patency. Conclusions: This study showed acceptable long-term primary and secondary patency rates after PTA for VVRS in ESRD patients, especially for those with VVRS located within 3 cm of the vein adjacent to the anastomosis.

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