Analysis of Factors Influencing Restenosis after Percutaneous Transluminal Angioplasty

Abstract

<b><i>Introduction:</i></b> This study aimed to analyse the influencing factors of arteriovenous fistula (AVF) ultrasound-guided restenosis after percutaneous transluminal angioplasty (PTA). <b><i>Methods:</i></b> This was a retrospective trial. The clinical data and ultrasound examination data of patients in maintenance haemodialysis who received ultrasound-guided PTA for AVF stenosis at our hospital from January 2018 to December 2020 were retrospectively analysed. The fistula patency and the relationship between age, dialysis age, fistula service age, combined hypertension, diabetes, hypoproteinaemia, stenosis type, fistula location, and patency rate after the operation were evaluated. <b><i>Results:</i></b> A total of 128 participants were evaluated. The results showed that being over 65 years old, with complications from hypertension, diabetes, and hypoproteinaemia, are all risk factors affecting the patency of postoperative internal fistulas. Compared with lumen stenosis, the patency rate of hyperplastic endothelial stenosis (<i>p</i> = 0.014) and thrombotic stenosis (<i>p</i> = 0.017) was lower, and the difference was statistically significant. The patency rate of the mixed site (<i>p</i> = 0.010), the anastomotic site (<i>p</i> = 0.041), and the cephalic vein near the anastomotic site (<i>p</i> = 0.018) was lower than the forearm cephalic vein, and the difference was statistically significant. <b><i>Conclusion:</i></b> Age, hypertension complications, diabetes complications, hypoproteinaemia, and the type and location of the AVF stenosis were essential for vascular patency of internal fistulas after PTA. Other risk factors of restenosis after PTA still need further research.

Risk Factors of Arteriovenous Fistula Stenosis of Patients with Maintenance Hemodialysis

“…Previous studies have shown that age, combined hypertension, diabetes, and hypoalbuminemia are the key factors causing arteriovenous fstula stenosis [8]. Evidence-Based Complementary and Alternative Medicine Te study also found a higher proportion of patients with diabetes and hypertension in the stenosis group than in the unobstructed group.…”

“…Previous studies have shown that age, combined hypertension, diabetes, and hypoalbuminemia are the key factors causing arteriovenous fistula stenosis [ 8 ].…”

“…Vascular diameter, gender, electrolyte level, and other factors may be important factors causing arteriovenous fistula stenosis. For example, long-term hyperphosphatemia can lead to vascular calcification, which affects the poor vasomotor function of vessels, and makes vessels prone to stenosis or even occlusion [ 8 ]. Therefore, the factors causing arteriovenous fistula stenosis need to be actively clarified, which plays an important role in improving the survival rate and quality of life of patients with maintenance hemodialysis.…”

Elevated plasma leptin levels are associated with vascular access dysfunction in patients on maintenance hemodialysis

“…4,5 Numerous studies have reported factors associated with VA malfunction, including sex, vascular diameter, electrolyte levels, VA condition (dialysis parameters and physical parameters), and comorbidities such as diabetes, obesity and hypertension. [6][7][8] Several molecular pathways, and especially inflammation pathways, have also been evaluated to determine the possible role in VA malfunction. 9,10 Nevertheless, the etiology of HEMO VA malfunction is still not fully understood.…”

“…A VA with good functional flow is vital for ESRD patients, 3 and VA malfunction can affect dialysis efficiency, patient quality of life, and increase hospitalization rate and medical costs 4,5 . Numerous studies have reported factors associated with VA malfunction, including sex, vascular diameter, electrolyte levels, VA condition (dialysis parameters and physical parameters), and comorbidities such as diabetes, obesity and hypertension 6–8 . Several molecular pathways, and especially inflammation pathways, have also been evaluated to determine the possible role in VA malfunction 9,10 .…”