关键词: 血液透析, 血管通路, 支架穿刺, 自体动静脉内瘘, 狭窄

Abstract: Objective:To explore the feasibility and effectiveness of puncture of arteriovenous fistula (AVF) stents in hemodialysis patients, providing a reference for clinical practice. Methods:A retrospective analysis was conducted on 16 patients who underwent stent placement for recurrent stenosis in the puncture area of AVF at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between November 2022 and September 2025, and subsequently used these stents for dialysis needle cannulation. Patient clinical data and postoperative follow⁃up information were collected. Calculate its technical success rate, clinical success rate, and the patency rates at 6 months and 12 months. Results:A total of 16 patients with AVF stenosis underwent stent implantation, including ELUVIA drug⁃eluting stents (12 stents in 11 patients) and bare⁃metal stents (nitinol stents) (5 stents in 5 patients). The technical success rate of stent implantation was 100%, and the success rate of initial stent puncture for dialysis was 100%. The primary target lesion patency rate at 6 months post⁃stent implantation was 100%. Within 12 months, restenosis occurred in 3 cases, resulting in a primary target lesion patency rate of 63.5%. The primary circuit patency rates at 6 and 12 months were 92.3% and 65.9%, respectively, while the secondary circuit patency rates were both 100%. The ELUVIA drug⁃eluting stent and the bare⁃metal stent (nitinol stent) both demonstrated a 100% primary patency rate of the target lesion at 6 months, with rates of 83.3% and 0% respectively at 12 months. During a mean follow⁃up of 302 days for stent cannulation, no complications such as stent fracture or infection were observed. Conclusion:Stent placement in the puncture area of AVF for hemodialysis needle cannulation demonstrates a high safety profile and favorable early and mid⁃term patency rates, indicating its feasibility for clinical application.

Key words: hemodialysis, vascular access, stent puncture, arteriovenous fistula, stenosis