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 procedure | After the procedure | p | |
| Diameter of brachial artery(mm) | 5.28±0.73 | 6.11±0.72 | 0.00 |
| Flow rate in brachial artery(ml/min) | 334.59±187.24 | 1026.19±268.46 | 0.00 |
| Diameter of feeding artery(mm) | 3.47±0.83 | 4.00±0.88 | 0.00 |
| Diameter of stenosis(mm) | 1.08±0.32 | 3.54±0.71 | 0.00 |
| PSV in stenosis(cm/s) | 417.96±168.73 | 271.46±100.42 | 0.00 |
| Diameter of draining vein(mm) | 3.91±0.93 | 4.32±0.87 | 0.00 |
| Flow speed in draining vein(cm/s) | 57.17±48.85 | 150.71±58.98 | 0.00 |
KM curve