Endovascular treatment of stenosis of autogenous arteriovenous access for hemodialysis.

Retrospectively review of long-term outcome of balloon angioplasty (TBA) in the treatment of native dialysis A-V fistulae stenosis was conducted. From February 2008 to January 2009, seven hemodialysis patients (5 women and 2 men; mean age 46.4 years) were treated for stenosis of the A-V fistula at the venous outflow tract. Angioplasty was performed with the use of high-pressure balloons. Percutaneous transluminal angioplasty was used. There were no any complications during and after procedure. In 4 cases residual stenosis did not exceed 10% and in 3 cases 30%. After 3 month the improvement rate was 85%. Two patients required surgical treatment. None of the patients displayed any major complications from the procedure. This study confirms the efficacy of PTA in the treatment of vascular access stenosis. Elevated dialysis blood line pressure can be the first sign of fistula stenosis. Although our series is small, we have nevertheless demonstrated that the concerted efforts of nephrologists, interventional radiologists, and surgeons are the key to maintaining and prolonging vascular access survival in this group of patients.