Factors affecting patency of arteriovenous fistula following first percutaneous transluminal angioplasty

Yap, Yit-Sheung; Chi, Wen-Che; Lin, Cheng-Hao; Liu, Yichun; Wu, Yi-Wen; Yang, Hui-Yueh

doi:10.1007/s10157-020-01958-w

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…However, these studies on usefulness of UG-PTA have short follow-up time and relatively small sample size [ 16 , 18 , 19 ]. Besides, the studies of affecting primary patency of AVF following UG-PTA were contradictory [ 20–22 ].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the primary patency of native arteriovenous fistulas after ultrasound-guided percutaneous transluminal angioplasty

Xing,

Li,

Yang

et al. 2023

Renal Failure

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Objective By analyzing the clinical history, laboratory test indexes, and intraoperative ultrasound imaging data of patients receiving ultrasound-guided percutaneous transluminal angioplasty (UG-PTA) for the first time, the application value of UG-PTA in the treatment of peripheral stenosis of autogenous arteriovenous fistula (AVF) and the related factors affecting postoperative patency were investigated. Methods A total of 381 patients with dysfunction of radio-cephalic AVF were treated with UG-PTA from June 2017 to September 2019. According to the inclusion and exclusion criteria, 199 patients were included in this study. Baseline characteristics of patients, including demographic, clinical, and laboratory data, were collected. Kaplan–Meier’s survival curve was used to demonstrate the cumulative primary patency rate of UG-PTA. Univariate and multivariate Cox regression analysis was performed on clinical, anatomic, biochemical, and medication variables to identify the predictors of postintervention primary patency. Results The early technical success rate of UG-PTA was 98.4% (375/381). One hundred and ninety-nine patients, with an average age of 52.9 years, were analyzed, 97 of whom were males (48.7%). The median follow-up duration was 21 months. No major complication was observed. Postintervention primary patency rates were 87.7%, 75.8%, and 60.0% at 6, 12, and 24 months, respectively. A previously failed AVF (HR, 1.935, 95% CI 1.071–3.494; p = .029) and an increased level of parathyroid hormone (HR per 100 pg/mL increase, 1.105; 95% CI 1.014–1.203; p = .004) were identified as independent negative predictors of primary patency of UG-PTA. Conclusions UG-PTA is a safe and effective method for the treatment of peripheral stenosis of AVF. Previously failed AVF and elevated parathyroid hormone levels are associated with lower primary patency rate.

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Section: Introductionmentioning

confidence: 99%

Factors affecting the primary patency of native arteriovenous fistulas after ultrasound-guided percutaneous transluminal angioplasty

Xing,

Li,

Yang

et al. 2023

Renal Failure

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“…However, clinical experience suggests that in many cases, patients will experience restenosis shortly after the first procedure with the need to repeat PTA. Many studies [4][5][6][7][8] believe that diabetes, fistula service life, fistula stenosis site, length, type, etc., may be the influencing factors for the patency rate after PTA. However, there is no consensus on the research results of influencing factors at home and abroad, and even the conclusions drawn by some studies are poor to some extent.…”

Section: Introductionmentioning

confidence: 99%

“…However, clinical experience suggests that in many cases, patients will experience restenosis shortly after the first procedure with the need to repeat PTA. Many studies [4‒8] believe that diabetes, fistula service life, fistula stenosis site, length, type, etc., may be the influencing factors for the patency rate after PTA.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Factors Influencing Restenosis after Percutaneous Transluminal Angioplasty

Luo¹,

Liu²,

Yang³

2022

Blood Purif

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Introduction: This study aimed to analyse the influencing factors of arteriovenous fistula (AVF) ultrasound-guided restenosis after percutaneous transluminal angioplasty (PTA). Methods: 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. Results: 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 (p = 0.014) and thrombotic stenosis (p = 0.017) was lower, and the difference was statistically significant. The patency rate of the mixed site (p = 0.010), the anastomotic site (p = 0.041), and the cephalic vein near the anastomotic site (p = 0.018) was lower than the forearm cephalic vein, and the difference was statistically significant. Conclusion: 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.

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“… 2 Maintaining primary access patency, preserving future vascular accesses and ensuring access functionality intended as a sufficient flow rate for successful hemodialysis are therefore matters of great interest. 3 The high rate of primitive and recurrent stenoses of AVFs lead to repeated endovascular interventions to maintain their assisted primary and secondary patency. 4 , 5 Herein, percutaneous transluminal angioplasty (PTA) has increasingly replaced the more invasive and less convenient surgical treatment of AVF malfunctions.…”

Section: Introductionmentioning

confidence: 99%

An unusual spontaneous recanalization by multiple palmar arteriovenous connections of a chronically occluded radiocephalic hemodialysis fistula

et al. 2022

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Preservation of a vascular access is crucial in the management of hemodialysis patients. In this regard, percutaneous transluminal angioplasty (PTA) is an effective tool if performed after an adequate understanding of preliminary fistulograms. The present case showed a chronic dysfunction of a radial-cephalic arteriovenous fistula (AVF) due to arterial occlusion and partially relieved by the spontaneous development of multiple small arteriovenous connections in the palmar region of the hand. This dense network had been so far able to ensure a sufficient retrograde blood flow for an effective hemodialytic performance. The angioplasty of the post-anastomotic stenotic segment of the radial artery was effective in restoring this neoformed AVF patency.

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Factors affecting patency of arteriovenous fistula following first percutaneous transluminal angioplasty

Cited by 10 publications

References 20 publications

Factors affecting the primary patency of native arteriovenous fistulas after ultrasound-guided percutaneous transluminal angioplasty

Factors affecting the primary patency of native arteriovenous fistulas after ultrasound-guided percutaneous transluminal angioplasty

Analysis of Factors Influencing Restenosis after Percutaneous Transluminal Angioplasty

An unusual spontaneous recanalization by multiple palmar arteriovenous connections of a chronically occluded radiocephalic hemodialysis fistula

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