Analysis of factors influencing patency rate of percutaneous transluminal angioplasty after first arteriovenous fistula stenosis

ObjectiveTo study the clinical effect of percutaneous transluminal angioplasty （PTA） in patients with first autologous arteriovenous fistula （AVF） stenosis， and to analyze the factors influencing the patency rate.MethodsA total of 82 patients with first AVF stenosis admitted in the Hemodialysis Center， Department of Nephrology， Central Hospital of Wuhan from March 2018 to September 2019 were recruited. A regression model was created， and a comprehensive clinical assessment was conducted. Gender， duration of dialysis， internal fistula age， presence of diabetes mellitus， stenosis location， upper-arm AVFs or not， venae fistula calcification， brachial artery diameter， peak systolic velocity （PSV） in the brachial artery， and preoperative and postoperative blood flow were analyzed for their association with PTA restenosis. Additionally， the postoperative primary patency rate was statistically evaluated.ResultsThe primary patency rate of 82 patients with AVF stenosis at 3， 6， 12， and 18 months after PTA was 93.9%， 81.7%， 63.4%， and 43.9%， respectively. The secondary patency rate at 3， 6， 12， and 18 months after PTA was 96.3%， 90.2%， 82.9%， and 74.4%， respectively. There were 46 cases of PTA restenosis， accounting for 56.1%， with an average occurrence time of 8.1±4.9 months. The primary patency rate was correlated with gender （<italic>P</italic>&lt;0.05）， higher upper-arm AVFs （<italic>P</italic>&lt;0.05）， venae fistula calcification （<italic>P</italic>&lt;0.001）， and brachial artery diameter （<italic>P</italic>&lt;0.05）. Multivariate Cox regression analysis showed that female， upper-arm AVFs and venae fistula calcification were factors influencing the primary patency rate after PTA. Female was a promoting factor of secondary endpoint events.ConclusionFemale， upper-arm AVFs， and venae fistula calcification were independent risk factors of AVF restenosis after PTA.