Clinical Efficacy and Safety of Ultrasound Guided Balloon Angioplasty for Immature Arteriovenous Fistula a Retrospective Cohort Study

Objective: To investigate the efficacy and safety of ultrasound-guided Percutaneous Transluminal Balloon Angioplasty (PTA) in the treatment of immature autologous Arteriovenous Fistula (AVF) for hemodialysis. Methods: A retrospective cohort study was conducted to analyze the clinical data of patients with immature AVF for hemodialysis and treated with ultrasound-guided PTA in the first affiliated hospital of Jinan University from January 2016 to December 2017. The Kaplan-Meier analysis was performed to estimate the primary patency rate of immature AVFs after PTA. Results: Twenty-five patients with immature AVFs for hemodialysis were included in this study. Among 25 immature AVFs, 8 (32%) had multiple stenosis, and 17 (68%) had a single stenosis with a total of 33 stenosis. All the 25 patients underwent ultrasound-guided PTA, the postoperative color Doppler ultrasound showed residual stenosis less than 30% and the technical success rates were 100%. AVF fremitus was obvious after surgery, and was used for hemodialysis with a pump blood flow of more than 230 ml/min, the clinical success rates were 100%. Three patients (12%) had the minor complication of hematoma, and there were no severe complications such as rupture of blood vessel, balloon rupture, and embolism. All the patients were followed up for 12 to 29 months, the primary patency rates were 96% at 3 months, 84% at 6 months, 54.2% at 12 months, respectively. Conclusion: Ultrasound-guided PTA is an effective method for the treatment of immature AVF. It also has a high technical success rate and clinical success rate with few complications.