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Introduction: Arteriovenous fistula (AVF) is the recommended access for patients in need for long term hemodialysis (HD). The primary dysfunction of AVF because of stenosis is a surgical problem and need to manage it. The aim of the study is to salvage AVFs by balloon angioplasty. Methods: a prospective clinical study was done from July 2019 to November 2022, including 42 dysfunctional native AVFs, and recommended for endovascular salvage. Follow up of patency of AVF along duration of the study (12 months) post-intervention using fistula-gram to estimate the success and patency rate with preserving function. Results: the study was done on 42 end stage renal disease (ESRD) patients. 42 AVFs, aged 45.6 ± 14.2 years, 27 (64.3%) were males, 15 (35.7%) were females, 3 (7.1%) patients were smokers, 33 (78.6%) of the patients were diabetics, 32 (76.2%) patients were hypertensive and 27 (64.3%) patients have ischemic heart disease. The stenotic lesions were detected in AVA in 4 (16.7%) patients, Juxtaanastomotic in 3 (12.5%) patients, Proximal venous outflow in 6 (25%), distal venous outflow in 7 (29.2%) and lesion in central venous in 2 (8.3%) patients. Success rate was recorded in 30 (71.4%) patients. Conclusion: Endovascular approach for treatment of non-functioning AVF is safe and efficient for maturation of the AVF and make it useful for hemodialysis.

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Background:The aim of the study was to evaluate the role of endovascular revascularization of the pedal vessels in diabetic patients with ischemic limbs on the rate of wound curing and healing and saving limbs. Methods: prospective interventional study over a period of 30 months, 63 diabetic patients presented with critical limb ischemia (CLI), subjected to angiography showed pedal arch defect in three groups: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA), and need revascularization. The rate and time of tissue healing and preservation of limb and avoid amputation were assessed using Kaplan-Meier curves between the different groups.Results: all patients in the study were divided into three groups, CPA group 22 patients (34.9%), IPA 28 patients (44.5%), and APA group 13 patients (20.6%), with no difference statistically in age, gender and other chronic illness. The rate of healing and time consumed for curing in CPA patients was remarkably than other, 90% in CPA, 69% in IPA, and 54% in the APA group (P=0.004). The time consumed was (3.7 + 2.3, 4.2 + 2.8 and 6.2 + 3.4) respectively (p=0.03) for healing. While the limb preservation rate was magnificent in CPA patients (100%), (86%) in IPA, and (61.5%) in APA group; P=0.01). no need for minor surgical intervention was accomplished in 85%, 74.3%, and 46.7% respectively (P=0.065). Conclusion:The endovascular intervention for dilatation of the pedal vessel has a great influence on saving the diabetic ischemic limbs, tissue preservation and improves their life.

Background: Femoral pseudoaneurysm considered the common complication of repeated femoral puncture during drug addiction by self-trials injections. Pseudo aneurysms form at the different sites arterial entrance (femoral, brachial, radial…) if not sealed, leaking of blood and result in a well formed pulsatile hematoma. This is a very crucial problem by the exponential growth of drug addiction. Methods:A prospective clinical trial study over a period of 20 months, 22 patients were attended complaining of a local pulsatile swelling at different site of recurrent drug injection and involved in this study. Antegrade or retrograde approach used depending on the site of the pseudoaneurysm and feeding neck. Excluded from study any patient presented with signs of infection or bleeding or treated by other method.Results: 22 patients, 20 were males and 2 were females. Age was 31.2 + 9.2 in years. The incidence of traumatic pseudo aneurysm between 15 -25 years old (45.5% of our cases ). the most common site forming pseudoaneurysm the groin (femoral artery), the antecubital region (brachial artery) and carotid artery (11) 44%, (8) 32% and 3 (12%) respectively. Management by endovascular covered stent may with different complications post intervention like 4.5% (one patient) thrombosis on brachial artery, endo-leak of the femoral artery ( one patient) and all managed with no residual complication and all patients passed well. Conclusion:endovascular intervention using covered stent to close the feeding neck, with less controllable complications and less hospitalization time.