Interventional Radiology Role in Management of AVF Stenosis by Doppler Ultrasound and Image Guided Angioplasty in Hemodialysis Patients

Background: There is a growing burden of chronic kidney disease (CKD) and the factors that produce it on the global population, as shown by the prevalence of CKD and the predicted growth of the renal population around the world. Aim: To evaluate the interventional radiology role in the management of arteriovenous fistula (AVF) Stenosis by Doppler US and image-guided angioplasty in patients with hemodialysis. Subjects and methods: Al-Azhar University's Interventional Radiology Unit at Sayed Galal University Hospital was the site of this prospective interventional trial. During the period from May 2024 to May 2025, twenty patients with End-Stage Kidney Disease (ESKD) who were regular hemodialysis patients and had vascular access problems were studied. Results: Access type was trans brachial artery in 5(25%) patients, Trans cephalic vein in 2(10%) patients, trans jugular vein in 6 (30%) patients, and trans radial artery in 7(35%) patients. Intervention type was balloon dilatation in 18(90%) patients and balloon dilatation and stenting in 2(10%) patients.Volume flow Pre-intervention ranged between 46-990mm with a mean (±SD) value of 393.7±283.22mm, and post-intervention ranged between 418-1438mm with a mean (±SD) value of 726.7±243.53mm. Volume flow was significantly higher post-intervention than pre-intervention (P-value<0.001).Regarding complications, 2(10%) patients had vascular spasm, 2(10%) patients had Hematoma and 1(5%) patient had Extra vasation. Conclusion: Doppler ultrasonography (US) is a non-invasive diagnostic method that may monitor the blood flow to an AVF and identify potential causes of vascular access dysfunction, making it an ideal tool for early detection of AVF problems. It was the initial imaging modality employed for non-functional AVF because of its low cost and availability.