LAUSR

PURPOSE The percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF) dysfunction has been increased as a salvage management, but its characteristics have not been confirmed. Therefore, we studied about clinical aspects of AVF PTAs. METHODS Between January 2013 and December 2016, a total of 551 vascular access (VA) PTAs were performed. VAs consisted of 285 AVFs and 266 AVGs. 285 AVFs included 163 brachiocephalic (BC) and 122 radiocephalic (RC) AVFs. For 285 AVF PTAs, we evaluated demographics, lesions and flows of AVF, patency rates of PTA, and stent insertions for refractory lesions of proximal vein (PV). RESULTS Stenosis was more prevalent than obstruction in both RC and BC AVF groups (P < 0.05). PV lesions were more prevalent in BC AVF group (P < 0.05). Primary patency rates of PTA were significantly lower in DM than non-DM group (P < 0.05), higher in stenosis than obstruction group (P < 0.05), and higher in smaller than larger numbers of lesion group (P < 0.05). All of 12 stents were inserted in PVs including subclavian vein in 4 cases and cephalic arch vein in 8 cases. Intervals of first to second PTA were significantly shorter in stent than non-stent group (P < 0.05). During 4 months postoperatively, AVF flows were significantly larger in stent than non-stent group (P < 0.05). CONCLUSIONS AVF PTA is a feasible and applicable modality for new onset and recurrence of AVF dysfunction. Also, we need to perform the early detection by regular surveillance and the proper management of AVF dysfunction.