title: Factors associated with patency following angioplasty of hemodialysis fistulae.
abstract: OBJECTIVE
  Patency after percutaneous transluminal angioplasty of native hemodialysis arteriovenous fistulae (AVFs) is highly variable. This study aimed to identify predictors of patency following angioplasty in native AVFs.
  
  
  METHODS
  All endovascular procedures performed in native AVFs between 2005 and 2013 at two institutions were retrospectively reviewed. Clinical, anatomic, biochemical, and medication variables were subjected to univariate and multivariate Cox regression analysis to identify predictors of postintervention primary and secondary patency.
  
  
  RESULTS
  During the study period, 207 patients underwent first angioplasty of their AVF. Follow-up ranged from 14 days to 8 years, during which another 247 endovascular interventions were performed to maintain patency. Postintervention primary patency rates at 6, 12, and 24 months were 66%, 49%, and 29%, respectively. Postintervention secondary patency rates at 6, 12, and 24 months were 94%, 84%, and 79%, respectively. On multivariate adjusted Cox regression analysis, upper-arm AVFs (P = .00072), AVFs less than 6 months of age (P = .0014), presence of multiple stenoses (P = .019), and degree of initial stenosis (P = .016) were significantly associated with shorter postintervention primary patency. A previously failed AVF was the only significant predictor of postintervention secondary patency loss (P = .0053).
  
  
  CONCLUSIONS
  Anatomic factors related to the AVF location, AVF age, and the extent of the lesion are important predictors of restenosis after balloon angioplasty. Traditional cardiovascular risk factors, metabolic and inflammatory markers, and medications were not associated with postintervention patency.
authors.affiliation: School of Medicine and Dentistry, James Cook University, Cairns, Australia. Electronic address: brendon.neuen@my.jcu.edu.au.
authors.forename: Brendon L
authors.initials: BL
authors.lastname: Neuen
authors.affiliation: School of Medicine and Dentistry, James Cook University, Cairns, Australia; Research and Development Unit for Primary Health Care and Dental Care, Southern Älvsborg County, Region Västra Götaland; Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ronny
authors.initials: R
authors.lastname: Gunnarsson
authors.affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Baer
authors.affiliation: Department of Vascular and Endovascular Surgery, Townsville Hospital, Townsville, Australia.
authors.forename: Patrik
authors.initials: P
authors.lastname: Tosenovsky
authors.affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, Australia.
authors.forename: Stella J
authors.initials: SJ
authors.lastname: Green
authors.affiliation: Department of Vascular and Endovascular Surgery, Townsville Hospital, Townsville, Australia; Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
authors.affiliation: Department of Renal Medicine, Cairns Hospital, Cairns, Australia.
authors.forename: Murty L
authors.initials: ML
authors.lastname: Mantha
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011793:Queensland; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency