Korean J Nephrol.  1999 Mar;18(2):277-283.

The Effect of Percutaneous Angioplasty on the Treatment of Stenosis and Obstruction of Arteriovenous Fistula in the Hemodialysis Patients

• Kim YO
• Shin MJ
• Song HC
• Yoon SA
• Kim YS
• Choi EJ
• Song HH
• Lee HK
• Bang BK

Abstract

Providing satisfactory vascular access for hemodialysis remains one of the most challenging problems confronting nephrologists. We evaluated the effect of percutaneous angioplasty on the treatment of stenosis and obstruction of arteriovenous fistula (AVF) in the chronic hemodialysis patients. Twenty-six dilatations of stenotic or occluded lesions in hemodialysis access fistulas were performed. The type of AVF was an native AVF in 19 cases and a graft in 7 cases. The lesions involved fore arm vein in 16 cases and an upper arm veins in 10 cases. Indications for angioplasty included acute obstruction of blood flow(9 patients), increased venous dialysis(VDP) or urea recirculation ratio(URR)(8 patients), arm edema or difficulty in needle placement(6 patients), poor maturation before first needling(3 patients). The PTA initially succeeded in 23 of 26 cases(88.5%) and 3 month patency rate was 80.5%. In 8 patients with increased VDP or URR, both VDP and URR significantly decreased after PTA (VDP;118.1+/-20.7mmHg vs 89.5+/-23.8 mmHg, P= 0.04, URR;23.9+/-18.4% vs 7.5+/-6.1%, P=0.02). The complications of PTA were vessel rupture(1 patient) and hematoma(2 patients). In conclusion, PTA seems to be effective therapy in the treatment of stenosis and obstruction of arteriovenous fistula(AVF) without serious complications in the chronic hemodialysis patients.

Keyword

Hemodialysis; Arteriovenous fistula; Venous stenosis; Venous obstruction; Percutaneous angioplasty

MeSH Terms

Angioplasty*
Arm
Arteriovenous Fistula*
Constriction, Pathologic*
Dilatation
Edema
Fistula
Humans
Needles
Renal Dialysis*
Transplants
Urea
Veins
Urea