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Abstract: TH-PO347

Primary Patency of Single-Needle Puncture for Arteriovenous Fistula Stenosis Resistant to High-Pressure Balloon

Session Information

  • Vascular Access - I
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Author

  • Huang, Xiao-mei, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Central Hospital,, Wuhan, Hubei Province, China
Background

To evaluate primary patency, safety and Doppler ultrasound data of single-needle puncture (SNP) treatment for AVF stenosis resistant to high-pressure balloon (HPB).

Methods

A retrospective study were conducted from June 2017 to August 2018 that included 83 patients who received PTA for AVF stenosis. Patients were allocated to SNP if AVF stenosis were resistant to HPB. Data collection included AVF stenosis location, stenosis length, percent stenosis, resident inner diameter, balloon pressure,intima thickness, mean access blood flow before and after intervention, complication and primary patency determined by Kaplan-Meier analysis.

Results

I type AVF stenosis (55.4%) were the most in 83 enrolled patients. Sixty-eight patients(81.9%) got technical success with HPB. The remaining 15 patients were allocated to SNP. Ten of 15 patients(88.0%)resistant to HPB got technical success with SNP. There were no significant difference in AVF stenosis location, stenosis length, residual inner diameter and percent stenosis between SNP and HPB. Balloon inflation pressure and inflation times during operation in SNP group ( 21.9±2.1 atm and 4.4±2.1 times )were higher compared with HPB (15.6±4.5 atm and 1.9±0.6 times ). The mean increases in access blood flow after PTA were 578.9±150.8ml/min with SNP and 487.2±100.5ml/min with HPB ( p=0.006 ). Primary patency were similar with SNP and HPB ( 63.6% v.s.66.5% in the 6th month and 14.5% v.s.7.7% in the 12th month, p=0.65). Intima were thicker in SNP group than HPB group before PTA(1.2±0.3 vs 1.0±0.3,p=0.029), but were similar 6 months after PTA(1.5±0.3 vs 1.3±0.4,p=0.24). No uncontrolled complication endangered AVF occurred.

Conclusion

SNP is a safe option for AVF stenosis resistant to HPB with satisfied primary patency and no more financial burden.

Funding

  • Government Support - Non-U.S.