title: Percutaneous Endovascular Treatment to Salvage Non-Maturing Arteriovenous Fistulas in a Multiethnic Asian Population.
abstract: BACKGROUND
  An arteriovenous fistula (AVF) is the preferred method for haemodialysis in patients with end-stage renal failure. Previous studies have shown value in attempting percutaneous transluminal angioplasty (PTA) to salvage AVFs that fail to mature, but they are relatively small in size and mainly reported in Western populations. We reviewed our data of PTA in non-maturing AVFs to establish whether this technique is translatable to our local multiethnic population.
  
  
  METHODS
  We retrospectively reviewed the medical records and procedural images of 105 patients who had PTA for non-maturing AVFs performed at our department from January 2008 to January 2011. Technical success was defined as ≤30% residual stenosis after angioplasty. Clinical success was defined as at least 1 successful haemodialysis session within 4 weeks after PTA.
  
  
  RESULTS
  All 105 patients underwent angioplasty for at least 1 haemodynamically significant stenosis. Six (5.7%) had additional embolisation of accessory veins. Technical success was achieved in 95.2% of cases. The clinical success rate was 76.2%. Primary patency rates at 3, 6 and 12 months were 83%, 45% and 28%, respectively. Secondary patency rates at 3, 6 and 12 months were 90%, 79% and 70%, respectively. The minor complication rate was 18.1%. No major complications were encountered. An average of 1.7 interventions per access-year was required to maintain AVF patency. Patients with a preoperative vein size >2.0 mm and age <55 years were more likely to achieve clinical success, although not statistically significant.
  
  
  CONCLUSIONS
  PTA is a viable option to help salvage non-maturing AVFs in a multiethnic Asian population.
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Wei Ping
authors.initials: WP
authors.lastname: Tham
authors.forename: Mark C
authors.initials: MC
authors.lastname: Burgmans
authors.forename: Bien Soo
authors.initials: BS
authors.lastname: Tan
authors.forename: Kiang Hong
authors.initials: KH
authors.lastname: Tay
authors.forename: Farah G
authors.initials: FG
authors.lastname: Irani
authors.forename: Apoorva
authors.initials: A
authors.lastname: Gogna
authors.forename: Ankur
authors.initials: A
authors.lastname: Patel
authors.forename: Richard Hg
authors.initials: RH
authors.lastname: Lo
authors.forename: Siew Ping
authors.initials: SP
authors.lastname: Chng
authors.forename: Hui Lin
authors.initials: HL
authors.lastname: Choong
authors.forename: Shaun Xjm
authors.initials: SX
authors.lastname: Chan
mesh_terms: D017130:Angioplasty / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical; D003251:Constriction, Pathologic / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D012846:Singapore; D014680:Veins