Abstract：Objective To explore the influencing factors of poor maturation of autologous arteriovenous fistula and the clinical effect of percutaneous transluminal angioplasty (PTA) treatment under ultrasound. Methods 124 patients with autologous arteriovenous fistula who were planned to undergo autologous arteriovenous fistula treatment in our hospital from August 2022 to July 2023 were selected to observe the occurrence of immature autologous arteriovenous fistula and analyze the clinical data differences between mature and immature patients. Patients with immature autologous arteriovenous fistula were given ultrasound guided PTA treatment to observe the treatment effect. Results Out of 124 patients, 32 had immature autologous arteriovenous fistula, incidence rate was 25.81%. The proportion of hypertension, diabetes and cardiovascular and cerebrovascular diseases in patients with immature autogenous arteriovenous fistula was 56.25%, 40.63% and 46.88%, respectively, which was significantly higher than that in patients with mature autogenous arteriovenous fistula. The diameter of the cephalic vein, the diameter of the posterior cephalic vein, and the diameter of the radial artery in patients with immature autologous arteriovenous fistula were (2.79±0.43) mm, (2.49±0.56) mm, and (3.37±0.61) mm, respectively, which were significantly smaller than those in mature autologous arteriovenous fistula patients, while the total cholesterol (TC) was (4.82±0.91) mmol/L, which was significantly higher than those in mature autologous arteriovenous fistula patients. Logistic regression analysis showed that hypertension, diabetes, the diameter of cephalic vein and radial artery were the influencing factors for the immature autogenous arteriovenous fistula, The model predicts that the area under the ROC curve for immature autologous arteriovenous fistula was 0.836(95% CI: 0.755-0.917), with predictive sensitivity and specificity was 81.30% and 76.30%, respectively, Patients with immature autologous arteriovenous fistulas were successfully treated with ultrasound guided PTA, with a maturation rate of 87.50% (28/32) at 1 monthaftersurgery. The blood flow, fistula vein diameter, and vascular wall thickness at 1months after surgery were (803.32±52.03) ml/min, (6.15±0.90) mm, and (0.73±0.18) mm, respectively, which were significantly increased compared to before surgery. Conclusion The immaturity of autogenous arteriovenous fistula is affected by hypertension, diabetes, the diameter of cephalic vein and radial artery. PTA under ultrasound has a good clinical effect on the immaturity of autogenous arteriovenous fistula, which is worthy of clinical use.
2024, Vol. 21 
