ISSN: 1859 - 2872
Endovascular intervention outcomes for dysfunctional hemodialysis arteriovenous fistulas: Preliminary results from a single center
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Abstract
Background: Chronic kidney disease (CKD) has proportionally increased with the aging population. Dialysis remains the most common renal replacement therapy, with arteriovenous fistulas (AVFs) being the preferred vascular access. AVF-related complications, including thrombosis, failure to mature, and stenosis, are major causes of access loss. Objective: To evaluate the outcomes of endovascular interventions for the treatment of AVF failure in hemodialysis patients. Subject and method: A retrospective, descriptive longitudinal study of consecutive patients with failing AVF undergoing percutaneous transluminal angioplasty (PTA) at Thong Nhat Hospital from June 2022 to January 2024. Treatment outcomes were assessed based on technical success rate, primary patency rate, and post-interventional complication rate. Result: Forty-one AVF interventions were performed. The most common lesion site was the anastomosis and juxta-anastomotic segment (75.6%). Technical success rate was 97.5%. Primary patency rates at 6 months and 1 year were 76.7% and 59.3%, respectively, for outflow stenosis; and 80% and 75% for central vein stenosis. No procedure-related mortality or major complications were recorded. Conclusion: Endovascular intervention is a safe and effective approach for AVF salvage, with satisfactory patency rates and low complication rates. Limitations include small sample size and inability to assess secondary patency.
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References
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