The Efficacy Of Percutaneous Transluminal Angioplasty For Treatment The Patients With Arteriovenous Fistula Dysfunction

BACKGROUND: The aim of this study was to evaluate the efficacy and outcomes of three different percutaneous transluminal angioplasty (PTA) approaches in the treatment of patients with arteriovenous fistula (AVF) dysfunction.METHODS:A retrospective review was performed in a total of 183 patients with AVF dysfunction treated with 3 different PTA approaches (transarterial, transvenous and combination) in our hospital from October 2006 to October 2012. Technical and clinical success rate, complications and vessel patency were assessed.RESULTS: The mean length of pretreatment stenosis segment was 2.0 +/- 1.4 cm (range 0.5-6.8 cm), and the mean length of stenosis segment was shortest in transvenous group. The technical success rates using transarterial and transvenous approach were 80.4% (P<0.01) and 87.8% (P<0.01), respectively, compared to 32.4% of combination approach. Moreover, the clinical success rates using transarterial and transvenous approach were 92.8% and 95.9% (P<0.01), respectively, comparing to 54.1% of combination approach. Moreover, significant difference was found on the presence of vasospasm among the three groups (P<0.01). In addition, a higher primary patency rate was also achieved by using transarterial (P<0.01) and transvenous approach (P<0.01) compared to combination approach.CONCLUSIONS: Transarterial and transvenous PTA is more efficient than combination PTA for the patients with dysfunctional AVF. A high technical and clinical success rate could be achieved by using both approaches. Limited number of complications and high rate of primary patency were found in the patients.