Correlation Analysis Of The Clinical Efficacy Of Ultrasound-guided PTA In The Treatment Of AVF Stenosis And Postoperative Restenosis

Object : To evaluate the clinical efficacy and application value of ultrasound-guided percutaneous transluminal angioplasty(PTA)in the treatment of arteriovenous fistulas(AVF)stenosis,And preliminary analysis of the related causes of AVF restenosis after PTA and appropriate intervention methods.Method:Fifty patients with end stage renal disease(ESRD)who underwent PTA surgery for AVF stenosis at the Third Affiliated Hospital of Nanchang University from February 2018 to December 2018 were selected.The changes of the inner diameter of stenosis,brachial artery blood flow and clinical dialysis blood flow before and after ultrasound-guided PTA were compared,and record the complications of intraoperative and postoperative.Follow-up observations were made on the use of internal fistulas in 50 patients after 1 month,3 months,6 months,and 9 months,and whether intervention was required,and the patency rate at various time points after PTA was obtained.Record the cause of AVF failure,the location of restenosis,the patient's age and related medical history.Result: The diameters of 50 patients with PTA before and after stenosis were(1.46 ± 0.28)mm and(2.86 ± 0.33)mm,and brachial artery blood flow were(259.74 ± 132.21)ml/min and(677.06 ± 152.67)ml/min,the clinical dialysis blood flow was(185.64 ± 10.73)ml/min and(207.40 ± 9.65)ml/min,and the difference was statistically significant(P <0.05).The success rate of PTA technology and clinical success rate were 100% and 96% respectively.The main complications during and after the operation were hematoma formation(4 cases,8%),thrombosis(2 cases,4%),dissection(2 cases,4%),and Pseudoaneurysm(1 case,2%).Within 1 month,3 months,6 months,and 9 months after operation,the patellar fistula patency rates were 100%,96%,90%,and 80%,The main causes of AVF failure are vascular stenosis and thrombosis,Including 6 cases of simple vascular stenosis,3 cases of thrombosis,1 case of vascular compression.Conclusion: Ultrasound-guided PTA for AVF stenosis is an excellent method that is minimally invasive,reproducible,low risk of infection,and ready for use after internal fistula,and is worthy of clinical application and promotion.The main causes of postoperative restenosis are endometrial hyperplasia,advanced age,vascular calcification,and vascular compression.For such patients,especially those with restenosis in the short term after surgery,more thorough planning may be required to choose the most appropriate treatment.In order to achieve better long-term efficacy and reduce patient economic pressure.