关键词: 动静脉内瘘狭窄, 紫杉醇涂层球囊腔内血管成形术, 初级通畅时间

Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the feasibility and effectiveness of ultrasound guided percutaneous paclitaxel-coated balloon angioplasty (PCBA) for the treatment of hemodialysis arteriovenous fistula stenosis in the real world.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 81 patients who received PCBA at Run Run Shaw Hospital, Zhejiang University School of Medicine from July 2018 to September 2023 and were followed up for at least six months were retrospectively included. Baseline data, technical success rate, clinical success rate, complications, and primary patency time were analyzed.
Ｒｅｓｕｌｔｓ：The PCBA technical success rate was 98.8%, same as the clinical success rate. No serious complications such as rupture of blood vessels was found. The length of the target lesion was 2.5 (1.15,4.15) cm, and the internal diameter of the target lesion was significantly improved after PCBA(4.35±0.82 mm vs 1.65±0.51 mm). The maximum intimal thickness of the target lesion was significantly reduced (0.72±0.19 mm vs 1.73±0.51 mm). Brachial artery flow was significantly increased［813(644,959)mL／min vs 362(267,513)mL／min］. The primary patency rates of target lesions at 3,6,12, and 24 months were 90.1%; 83.9%; 52.8%; 36.7%. The primary patency rates of autologous fistula venous target lesion and stent target lesion at 3, 6, 12 and 24 months were 89.7%, 84.5%, 59.5%, 42.2% and 92.9%, 85.7%, 56.9%, 38.4% respectively.
Ｃｏｎｃｌｕｓｉｏｎ：PCBA can significantly improve the inner diameter of the target lesions as well as brachial artery flow. It also can improve the primary patency rate of the target lesions of the fistula vein in the autologous fistula and in-stent restenosis. Ultrasound can clearly, accurately and safely guide paclitaxel drug-coated balloon to relieve arteriovenous fistula stenosis.

Key words: arteriovenous fistula stenosis, paclitaxel-coated balloon angioplasty, primary patency time