title: Factors influencing technical success and outcome of percutaneous balloon angioplasty in de novo native hemodialysis arteriovenous fistulas.
abstract: OBJECTIVE
  To determine predictors of technical success, dysfunction recurrence and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVFs).
  
  
  METHODS
  Retrospective analysis of first time PTA of 167 AVF in 162 patients (100 men, 66±13 years). Anatomical (location, length, grade and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus and AVF age, side and location) were reviewed.
  
  
  RESULTS
  217 stenoses or segmental occlusions were treated. Technical success rate (84.4%) was higher in radiocephalic AVF compared to brachial artery-median vein AVF (p=0.030) and was negatively correlated with initial stenosis (p=0.049). Dysfunction recurrence was seen in 52.7% and correlated negatively with technical success (p=0.013) and AVF age (p=0.008). Early dysfunction (within 6 months) was negatively correlated with AVF age (p=0.016) and positively with diabetes (p=0.003). Higher AVF age resulted in higher primary (p=0.005) and secondary patency rates (p=0.037-0.005).
  
  
  CONCLUSIONS
  Technical success of PTA in hemodialysis AVF is affected by AVF type and initial stenosis and has significant effect on dysfunction recurrence, but not on AVF longevity. Younger AVF has increased risk for (early) recurrent dysfunction and lower patency rates. Patients with diabetes mellitus have higher risk for early dysfunction.
authors.affiliation: University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven, Belgium. sam.heye@uzleuven.be
authors.forename: Sam
authors.initials: S
authors.lastname: Heye
authors.forename: Geert
authors.initials: G
authors.lastname: Maleux
authors.forename: Johan
authors.initials: J
authors.lastname: Vaninbroukx
authors.forename: Kathleen
authors.initials: K
authors.lastname: Claes
authors.forename: Dirk
authors.initials: D
authors.lastname: Kuypers
authors.forename: Raymond
authors.initials: R
authors.lastname: Oyen
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000706:statistics & numerical data*; D000800:Angioplasty, Balloon / Q000706:statistics & numerical data*; D001530:Belgium / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult