ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2018, Vol. 27 ›› Issue (6): 533-537.DOI: 10.3969/j.issn.1006-298X.2018.06.007

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Ultrasoundguided percutaneous transluminal angioplasty in treatment of arteriovenous graft stenosis

  

  • Online:2018-12-28 Published:2019-01-21

Abstract:

Objective:To summarize the effect of ultrasoundguided percutaneous transluminal angioplasty(PTA) in treatment of arteriovenous graft (AVG) stenosis.
Methodology:The clinical data of One hundred twelve patients with AVG stenosis treated by ultrasoundguided PTA were retrospectively analyzed.
Results:Vein anastomosis occurred in 618%,while arterial anastomosis 132%,artificial vascular puncture point 153% and drainage vein 83% of the total stenotic sites.687% of the patients were stenosis accompanied thrombosis,while 313% were  stenosis only.The degree of vascular stenosis in patients with thrombosis was severer than that in patients with  stenosis only(871%±62% vs 710%±74%,P<005).However,there was no significant difference in the composition of stenotic sites between these two groups.The success rate of operation was 965%,and technical success rate of balloon dilation was 100%.More than 70% of the stenosis required dilatation pressure of at least 14 atm.The primary patency rate of AVG after PTA was 688%±50% in 6 months and 253%±42% in 12 months,while the secondary patency rate was 986%±17% in 6 months and 802%±63% in 12 months respectively.
Conclusion:The most common site of AVG stenosis is venous anastomosis.Stenosis is the main cause of thrombosis in AVG,and reasonable management of stenosis is the key of preventing thrombosis.Thrombosis of AVG is not related to the location of stenosis,but depends mainly on the degree of stenosis.Ultrasoundguided PTA is a safe and effective treatment for AVG stenosis.The hemodynamics of AVG determines high incidence of stenosis in specific location and low primary patency rate,but higher secondary patency can be achieved by repeated PTA treatment.

 

Key words: arteriovenous graft, percutaneous transluminal angioplasty, ultrasoundstenosis