Percutaneous Transluminal Angioplasty as a Treatment of Arteriovenous Fistula Stenosis for Hemodialysis

Abstract Background The main option of renal replacement therapy (RRT) in patients with end stage renal disease (ESRD) is still the hemodialysis (HD). The cornerstone of efficient hemodialysis is the ability to maintain a proper vascular access. The first recommended type of vascular access is the native arteriovenous fistula (AVF) which has a higher patency and lower complication rates compared to other access types such grafts and catheters. Dysfunctional vascular access is a major cause of hospitalization and morbidity in hemodialysis patients. Objective To evaluate the endovascular option for treatment of arteriovenous fistula failure stenosis regarding success rates and primary patency rate after the angioplasty procedure at 3, 6 months. Methods This is a non-randomized prospective study was conducted at Ain Shams University hospital and Ahmad Maher Teaching hospital. Involving 30 patients having End Stage Renal Disease (ESRD) with failing native AVF. Results Percutaneous transluminal angioplasty (PTA) for dysfunctional AVF is an excellent treatment option for AV fistula stenosis. As it has the following advantages: It is more durable than the creation of new access or the catheter placement. Percutaneous transluminal angioplasty (PTA) is relatively simple, less invasive, enables us to spare other access sites for further use, helps in minimizing the insertion of central catheters and allowed the patient to start dialysis in the day after intervention. Conclusion PTA has several advantages as it can be considered a safe procedure with low complication rate, less invasive, shorter procedure, enables immediate dialysis without using of central venous catheter, reduces the risk of infection, doesn’t exhaust the patient’s veins and spares them for further use and can be repeated several times before abandoning the fistula.