Primary investigation of the intervention therapies to arteriovenous fistula stenosis

Objective: To explore the intervention therapy to arteriovenous fistula (AVF) stenosis in hemodialysis patients and analyze the fistula dysfunction rate after the intervention treatment. Methods: Twenty-four AVF stenosis patients were enrolled. Percutaneous angiographies and intervention therapies were carried out. The position and number of AVF were analyzed, and meanwhile the intervention therapy approaches were evaluated. The patency rates in half a year after intervention treatment to AVF were analyzed by K-M curve. Results: There were forty stenoses in all patients with AVF. Twelve patients had two stenosis, two patients had three stenoses while the rest only had one. Ail patients received endovascular therapy except one with guide wire failing to pass through the stenosis received other therapies. The stenosis mostly lied in the peri-anastomotic region and the puncture segment of fistula. These two stenosis sites occupied ninety-five percent of all lesions. Twenty-one patients received percutaneous transluminal angioplasty, and two received stent implantation after angioplasty. After intervention therapy, twenty-two AVF were recovered to patency immediately and by the end of six months seventeen fistulas still kept well. The ninety-five percent confidence interval of patency was 4.410 to 5.940. Conclusion: The AVF stenosis mostly lies in the peri-anastomotic region and the puncture segment Though the possibility of immediate patency of fistula after intervention treatment is high, a part of patients have to suffer the dysfunction of fistula again after six months. (authors)