Objective To compare the patency outcomes of percutaneous transluminal angioplasty (PTA) in patients with forearm arteriovenous fistula (AVF) stenosis and investigate the efficacy of high-frequency ultrasound-guided PTA and prognostic factors influencing post-operative patency. Methods A total of 134 patients with forearm AVF stenosis treated at the Blood Purification Center of Beijing Nuclear Industry Hospital and Friendship Hospital of Capital Medical University from June 2022 to February 2024 were retrospectively analyzed. Patients were classified into four groups based on stenosis location: Type I (n=45, anastomotic stenosis), Type II (n=43, venous outflow stenosis), Type III (n=21, mixed stenosis), and Type IV (n=25, venous valve stenosis). All patients underwent ultrasound-guided PTA. Collect baseline patient data (age, gender, underlying diseases, etc. ) and pathway characteristics (anastomosis angle, puncture method, blood flow, etc. ), and use a multivariable Logistic regression model to analyze the independent risk factors affecting postoperative patency rates. Results Significant differences were observed in access usage duration among groups (Type I<Type II<Type III), with the shortest (1.48 years) in Type I and longest (6.65 years) in Type III. Post-PTA, residual stenosis diameter and brachial artery blood flow significantly improved in all groups. No intergroup differences in 1-, 3-, and 6-month patency rates were found, but 9-month patency rates differed significantly, with the most pronounced difference between Type II and Type IV. Multivariate Cox regression identified anastomotic angle<30°(OR=3.525, P<0.05), regional puncture (OR=2.151, P<0.05), blood flow>3 000 mL/min (OR=2.238, P<0.05), and diabetes mellitus (OR=2.808, P<0.05) as independent risk factors for Type I-IV stenosis, respectively. Conclusion High-frequency ultrasound-guided PTA effectively treats forearm AVF stenosis across all four types. Stenosis classification, anastomotic angle, puncture technique, and diabetes mellitus are critical determinants of post-operative patency.
Key words
color doppler ultrasonography /
arteriovenous fistula /
percutaneous transluminal angioplasty /
patency rate
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