Percutaneous transluminal angioplasty (PTA) has proved to be an effective method for dilating stenoses in veins and arteries used for vascular access in haemodialysis. Not only can stenoses of arteriovenous fistulae (Cimino and other types) be treated, but stenoses of arteriovenous shunts (Scribner) can also be successfully dilated. Over a period of 3 years, PTA was applied 94 times in a haemodialysis population of about 50 patients. It reduced the number of surgical interventions required to maintain permanent vascular access by 30%. The longevity of external and internal shunts was increased by nearly 2 months and 1 year respectively with a PTA. Repeated PTAs were often possible. During the 3 years that PTA was practised routinely, there was a 50% reduction in the number of operations with stenosis as indication as compared to the 3 preceding years.

Image quality and anatomic depiction with flow-interrupted contrast-enhanced MR angiography and with DSA were comparable.

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These data demonstrate that a vascular access QIP resulted in placement of more autogenous AVFs, increased number of PTAs and surgical interventions. These findings suggest that a vascular access care QIP is worthwhile to improve dialysis patients' care and access morbidity.