Efficacy Of DSA Guided Percutaneous Angioplasty And Color Ultrasound-Guided Percutaneous Angioplasty In The Treatment Of Arteriovenous Fistula Stenosis In Dialysis Patients

Objective To observe and compare the therapeutic effect of PTA guided by DSA and color ultrasound in the treatment of arteriovenous fistula stenosis in dialysis patients.Methods A total of 78 hemodialysis patients with arteriovenous fistula stenosis admitted to The Third Affiliated Hospital of Bengbu Medical Colleg from January2017 to September 2019 were retrospectively analyzed.According to different surgical methods,they were divided into DSA group(43 cases)and color ultrasound group(35 cases).The incidence of postoperative complications was compared between the two groups.The changes in the internal diameter,dialysis blood flow,and brachial artery blood flow of the two groups before and after surgery were compared.The incidence of fistula restenosis and primary patency within 1,3,6,and 9monthsafter operation were observed.Results The incidence of postoperative complications in DSA group and color Doppler ultrasound group was 2.33% and8.57% respectively,and the difference was not statistically significant(p>0.05).There were no significant differences in the preoperative diameter of stenosis(1.36±0.37 mm vs 1.33±0.56mm),hemodialysis blood flow(164.29±14.41ml/min vs170.29±19.17ml/min),and humerus arterial blood flow(380.00±29.90ml/min vs395.14±43.14ml/min)between the two groups(t=0.258,-1.394,-1.601,P>0.05).There was no statistical significance in the difference of the stenosis diameter,hemodialysis blood flow and humerus arterial blood flow between 2 groups 1 day after surgery and before surgery(2.01±0.37 mm vs 2.15±0.72 mm,59.71±20.22ml/min vs 50.86±24.42ml/min,430.57±55.94ml/min vs 424.86±43.82 ml/min)(t=-1.226,1.594,0.527,P>0.05).The primary patency rates of the DSA group at 1,3,6 and 9months after operation were 97.67%,97.67%,90.07% and 79.07%,respectively.The primary patency rates of color ultrasound group were 97.14%,94.29%,85.71%and 77.14%,respectively,and the difference was not statistically significant between the two groups(P>0.05).Conclusion PTA is effective in the treatment of arteriovenous fistula stenosis.DSA and color ultrasonography guided PTA have the same therapeutic effect on arteriovenous fistula stenosis.Compared with the traditional DSA,color ultrasound has the advantages of simple operation,non-invasive,non-radiation,high repeatability and relatively low cost.