title: Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency.
abstract: OBJECTIVE
  We aimed to determine the predictors of technical success and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVF).
  
  
  METHODS
  We performed a retrospective analysis of first time PTA in 228 patients (129 men, 99 women; mean age, 56.8±14.6 years). Anatomical (location, length, grade, and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus, AVF age, side, and location) were reviewed.
  
  
  RESULTS
  A total of 330 stenoses were found in 228 patients. PTA was technically successful in 96.3% of the stenoses (n=319). Clinical success was achieved in 97.2% (n=321). Early dysfunction (within six months) was positively correlated with patient age (P < 0.001) and diabetes (P < 0.005). Older age (P < 0.001) and diabetes (P = 0.002) were associated with a lower primary patency rate. Patient age (P %lt; 0.001), presence of diabetes (P = 0.023), length of stenosis (P = 0.003), early recurrence (P = 0.003) and presence of residual stenosis (P = 0.014) were associated with a lower secondary patency rate.
  
  
  CONCLUSIONS
  Patency of dysfunctional hemodialysis fistulas can be maintained safely with continuous follow-up and repeated interventions without shortening the venous segment by surgical revision. Percutaneous approach to hemodialysis access stenosis is an alternative to the conventional surgical approach and PTA is an effective treatment method for dysfunctional AVF.
authors.affiliation: Department of Radiology, Turgut Özal University School of Medicine, Ankara, Turkey. aysedag2029@yahoo.com.
authors.forename: Ayse
authors.initials: A
authors.lastname: Aktas
authors.forename: Alper
authors.initials: A
authors.lastname: Bozkurt
authors.forename: Bulent
authors.initials: B
authors.lastname: Aktas
authors.forename: Ismail
authors.initials: I
authors.lastname: Kirbas
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D000800:Angioplasty, Balloon / Q000379:methods*; D001164:Arteriovenous Fistula / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency