Efficacy of ultrasound-guided percutaneous transluminal angioplasty for arteriovenous fistula stenosis or occlusion at juxta-anastomosis: A 3-year follow-up cohort study

作者全名："Gu, Hui; Wan, Ziming; Lai, Qi-Quan; Zhou, Yu; Tu, Bo; Hu, Bo; Chen, Ling; Gao, Xue-Jing"

作者地址："[Gu, Hui; Wan, Ziming; Lai, Qi-Quan; Zhou, Yu; Tu, Bo; Chen, Ling; Gao, Xue-Jing] Chongqing Med Univ, Dept Nephrol, Affiliated Hosp 1, Youyi Rd 1, Chongqing 400042, Peoples R China; [Hu, Bo] Jinan Univ, Dept Nephrol, Affiliated Hosp 1, Guangzhou, Peoples R China"

通信作者："Wan, ZM (corresponding author), Chongqing Med Univ, Dept Nephrol, Affiliated Hosp 1, Youyi Rd 1, Chongqing 400042, Peoples R China."

来源：JOURNAL OF VASCULAR SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000664291100028

JCR分区：Q1

影响因子：4.3

年份：2021

卷号：74

期号：1

开始页：217

结束页：224

文献类型：Article

关键词：Arteriovenous fistula; Juxta-anastomosis; Stenosis; Ultrasound; Percutaneous transluminal angioplasty

摘要："Objective: Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty (PTA) has become a choice for AVF stenosis, and ultrasound has been used in PTA more frequently. Methods: This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First Affiliated Hospital of Chongqing Medical University from January 2016 to December 2016. Angioplasty was performed using a noncompliant high-pressure balloon. The process was visualized by duplex scan. Our inclusion criteria were as follows: (1) stenoses or occlusions were located at the juxta-anastomosis site: the first 5 cm of the vein distal to the anastomosis; (2) stenosis was confirmed with the following conditions: (a) flow rates are <500 mL/min in the brachial artery and <200 mL/min in the fistula during dialysis, and (b) the stenosis diameter is <1.7 mm. We used the Kaplan-Meier curve to show the postintervention primary and secondary patency rates of patients with stenosis and occlusion. Results: Altogether, 129 patients with 76 males were analyzed. Moreover, 104 have AVFs on the left arm, and only one patient had an ulnar-basilic AVF, whereas others had a radial-cephalic AVF. The postintervention primary patency rates are better in occlusion cases (P<.05), whereas secondary patency rates have no difference. The postintervention primary patency rates are better in patients without diabetes mellitus (P<.05), whereas the secondary patency rates had no difference. Conclusions: For juxta-anastomosis site stenosis or occlusion, PTA can be used to obtain satisfactory results."

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