Abstract: Objective: To evaluate the efficacy and safety of peripheral cutting balloon (PCB) in the treatment of arteriovenous fistula (AVF) anastomotic area stenosis.
Methodology: A single-center, retrospective observational study. 69 patients received percutaneous transluminal angioplasty (PTA) treatment due to intra-arteriovenous fistula stenosis received at the renal Department of Haidian Hospital, Peking University Third Hospital from March 2022 to March 2023. Clinical data and postoperative follow-up data were collected, and the patency rate of 6 and 12 months after surgery was calculated, and the related risk factors affecting the patency after PCB surgery were analyzed accordingly.
Results: A total of 69 patients were included, and the technical success rate after PCB operation was 97.14%, and the clinical success rate was 100%. Kaplan-Meier survival analysis showed that 6 cases of restenosis occurred within 6 months after PCB treatment, and the primary patency rate was 91.3%. Restenosis occurred in 18 cases within 12 months, and the primary patency rate was 71.4%. The secondary patency rate at 6 months and 12 months was 100%. The 12-month Kaplan-Meier survival curve indicated that the patency rate of the anastomotic artery was higher (Log-rank χ²=19.98, P<0.001), and the patency rate of the lesion length less than 2 cm was higher (Log-rank χ²=10.13, P=0.001). COX multivariate regression analysis showed that: The stenosis of the anastomotic artery [HR 0.081 (0.015,0.430), P=0.003], the length of the lesion less than 2cm [HR 0.235 (0.062,0.893), P=0.034], preoperative narrowest inner diameter [HR 4.060 (1.160,14.300), P=0.029], hemoglobin [HR 11.000 (1.960,62.100), P=0.007] and platelet [HR 3.270 (1.070,9.970), P=0.037] are the main risk factors affecting the stenosis clearance rate of the anastomotic area in the cutting balloon treatment.
Conclusion: PCB angioplasty is an effective method for the treatment of AVF anastomotic stenosis, with high immediate success rate, good long-term patency rate, safe and reliable. Has a high success rate and reliable patency. The results of COX multivariate analysis can be understood as independent risk factors, adding preoperative vascular stenosis site, length, preoperative narrowest inner diameter, hemoglobin, platelet.

Key words: font-family:Inter, -apple-system, BlinkMacSystemFont, ", font-size:16px, background-color:#F9FAFB, ">vascular access, peripheral cutting balloon, arteriovenous fistula, anastomotic stenosis