On Postoperative Day Balloon Angioplasty for Salvage of Newly-Placed, Flow-Limiting Native Arteriovenous Fistula.

PURPOSE

To report result and usefulness of immediate postoperative balloon angioplasty of de novo arteriovenous fistula (AVF) with limited flow just after creation.

MATERIALS AND METHODS

From January 1, 2012 to March 31, 2014, 1,270 patients received native AVF creations in a single vascular clinic. In twenty-four patients (1.9% of total AVF creation), immediate postoperative balloon angioplasty was performed because of limited flow on palpation (only pulsation or no thrill) just after AVF creation. Medical records were reviewed retrospectively; technical success (restoration of AVF flow)/clinical success (growing as functional AVF) rate, maturation time, primary patency rate and fistula survival outcome were analyzed during a mean 10.8 months of follow-up.

RESULTS

Technical/clinical success rate was 95.8% (23/24 cases); AVF flow was restored after balloon angioplasty, and all the flow-restorated AVFs grew as functional AVFs with mean±standard deviation, 4.5±1.5 weeks of maturation time. In seven (30.4%) patients, a secondary balloon angioplasty was needed to enhance maturation. The overall primary patency after immediate postoperative balloon angioplasty was 69.6% at 1 and 6 months and 59.0% at 12 months. There was 1 complication (operation site hematoma).

CONCLUSION

Immediate postoperative balloon angioplasty for salvage of newly-placed, flow-limiting native AVF is a useful, effective and safe procedure.