Application value of balloon dilation guided by color doppler ultrasound in vascular access stenosis

ObjectiveTo compare the efficacy between balloon dilatation guided by color ultrasound and surgical reconstruction in the treatment of hemodialysis autogenous fistula anastomotic proximal stenosis(within 2 cm from the anastomosis).

MethodsThe clinical data of 69 patients with arteriovenous fistula anastomotic proximal stenosis were retrospectively analyzed.The patients were divided into the group A(36 cases treated with percutaneous transluminal angioplasty(PTA) and group B(33 cases treated with revascularization surgery).The patency rates in two groups at 1, 3 and 6 months of after treatment were evaluated.

ResultsThe dialysis time, clinical success rate and technical success rate in group A were(4.11±3.06) years, 97% and 100%, respectively.The dialysis time, clinical success rate and technical success rate in group B were (3.85±2.81) years, 94% and 100%, respectively.The patency rates in A group at 1, 3 and 6 months after treatment were higher than that in group B(P < 0.05).There was no statistical significance in the incidence rate of complications between two groups(P>0.05).There was no statistical significance in the intravascular diameter of internal fistula stenosis and brachial artery blood flow between two groups before operation and after 1 month of operation(P>0.05).The blood vessel diameter and blood flow in two groups after operation were significantly greater than those before operation(P < 0.01).

ConclusionsThe effects of balloon dilatation guided by color ultrasound and surgical reconstruction in the treatment of hemodialysis autogenous fistula anastomotic proximal stenosis are the same.The balloon dilatation guided by color ultrasound is simple, the patients can be dialysed after operation, the vascular resources can be preserved, so which can be recommended as the preferred treatment for arteriovenous fistula anastomotic proximal stenosis.