Endovascular Management of Stenosis in Renal Dialysis Arterio-venous Fistula

Introduction: Malfunctions of arteriovenous fistulas (AVFs) for hemodialysis are a major cause of morbidity and hospitalization, including thrombosis and stenosis. In 90% of cases a stenotic process is the origin of thrombosis. To manage this problem, it requires a multidisciplinary approach.

Method(s): This is experience of our department; between January 2018 and June 2022, 38 patients (25 men, 13 women) with autologous AVF stenosis were treated with percutaneous angioplasty. Of these, 26 patients had a brachio-cephalic fistula, 7 had brachio-basilic, and 5 radio-radial ones. Patients were diagnosed with AVF stenosis during clinical surveillance. The diagnostic was confirmed with Doppler ultrasound or fistulography.

Result(s): The technical success rate was 83.34%. In 16.66% it was a resistant stenosis which required a surgical treatment. We did not need to place any stent. The follow-up period ranged from 5 to 50 months in the form of clinical follow-up during dialysis. The primary patency was respectively 84 and 74%.

Conclusion(s): Correction of hemodynamically significant stenosis with percutaneous angioplasty reduces the rate of thrombosis and prolongs the lifetime of AVF in chronic hemodialysis patients.

Publication History

Article published online:
09 February 2023