The efficacy of percutaneous transluminal angioplasty treatment for 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.