Role of Balloon Angioplasty in Non-mature Arteriovenous Fistula caused by Stenosis
Almetwaly Ragab Ragab Ibrahim
Vascular Surgery Department; Faculty of Medicine (Damietta), Al-Azhar University
Journal Title:International Journal of Medical Arts
Background: Arteriovenous fistula (AVF) is a significant procedure for patients in need for hemodialysis. Failure of maturation due to stenosis is a challenge, which need further intervention.
Aim of the work: To present our experience in therapeutic intervention for non-mature arteriovenous fistula caused by stenosis using balloon angioplasty.
Patients and Methods: 25 patients who had stenosis of primary AVF were included. The mean age was 57.28±6.97 years and patients were 16 males and 9 females. Patients were Followed-up every three months up to 1 year. Collected data included patient demographics, cause of renal failure, characters of primary AVF, and variables of balloon angioplasty (e.g., clinical success and complications), primary patency and recurrence of stenosis.
Results: AVF type was radiocephalic (60.0%), brachiobasilic (24.0%) and brachiocephalic (16.0%). The fistula segment was juxta-anastomotic (44%), anastomosis (36.0%) and efferent in 20.0%. Technical success was 100%; the patency rate at 6 months was 80.0%, at 9 months was 64.0% and at 12 months was 56.0%. There was puncture site hematoma in 2 patients (8.0%) that were treated conservatively. The recurrence was reported in 9 patients (36.0%) (8 cases due to re-occlusion and one patient due to thrombus formation). Recurrence was significantly associated with older age and high coronary artery disease.
Conclusions: Balloon angioplasty is effective and safe procedure for treatment of AVF non-maturation due to stenosis.