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Abstract: TH-PO340

Ultrasound-Guided Percutaneous Transluminal Angioplasty for Stenosis and Occlusion in Juxta-Anastomosis Arteriovenous Fistula: A Single Center Research Study

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

Authors

  • Ziming, Wan, the First Affilicated Hospital of Chongqing Medical University, Chongqing, China
  • Gu, Hui, the First Affilicated Hospital of Chongqing Medical University, Chongqing, China
Background

Arteriovenous fistula (AVF) is the preferred access for hemodialysis.Percutaneous transluminal angioplasty(PTA) has become a choice for AVF stenosis and ultrasound has been used in PTA more and more frequently.

Methods

In 2016,192 patients underwent PTA in our hospital.Angioplasty was performed using a non-compliant high pressure balloon.The process was visualized by duplex scan.Our inclusion criteria were:1)Stenosises or occlusions were located at juxta-anastomosis:the first 5cm of vein distal to the anastomosis;2)Stenosis was confirmed with conditions:a.flow rate is<500ml/min in brachial artery and<200ml/min in fistula during dialysis;b.diameter of stenosis is<1.7mm.

Results

129 patients with 76 males were analyzed.104 of them have AVFs on left arm,and there is one Ulnar-basilic AVF while others are Radial-cephalic AVF.
The comparasion of variables are presented in the table.
We use Kaplan-meier curve to show the primary and secondary patency rates of patients with stenosis and occlusion respectively.The primary patency rates are better in occlusion(P<0.05),while secondary patency rates have no difference.The primary patency rates are better in patients without diabetes mellitus(P<0.05)while the secondary patency rates had no difference.

Conclusion

For the juxta-anastomosis's stenosis or occlusion,PTA can be used to obtain satisfactory results.

variables comparison
 Before the procedureAfter the procedurep
Diameter of brachial artery(mm)5.28±0.736.11±0.720.00
Flow rate in brachial artery(ml/min)334.59±187.241026.19±268.460.00
Diameter of feeding artery(mm)3.47±0.834.00±0.880.00
Diameter of stenosis(mm)1.08±0.323.54±0.710.00
PSV in stenosis(cm/s)417.96±168.73271.46±100.420.00
Diameter of draining vein(mm)3.91±0.934.32±0.870.00
Flow speed in draining vein(cm/s)57.17±48.85150.71±58.980.00

KM curve