Efficacy And Influencing Factors Of Percutaneous Transluminal Angioplasty Guidanced By Ultrasound

Objective: Percutaneous transluminal angioplasty(PTA)guided by ultrasound has been widely used clinically in the treatment of autologous arteriovenous fistula(AVF)stenosis in dialysis patients.This study is to explore the primary patency rate,the efficacy of repeated PTA and related factors affecting the primary patency rate of AVF after PTA.The aim is to intervene AVF stenosis better,prolong the use of internal fistula,and reduce hospitalization rate of patients.Methods:We performed PTA guided by ultrasound in 87 maintenance hemodialysis patients who were hospitalized because of AVF stenosis in Dongfeng Hospital affiliated to Hubei University of medicine from June 2017 to June 2019.Kaplan-Meier and Log-Rank method were used to analyze the Factors that may affect postoperative patency rate,such as age,gender,coronary heart disease,diabetes,the use time of internal fistula,the number of stenosis and the degree of stenosis.The factors that were of Statistical significance in the univariate Kaplan-meier were analyzed by Cox multivariate regression analysis to pick up the related factors that affect the primary patency rate of AVF after the first PTA guided by ultrasound.Survival analysis was performed to get the primary patency rate at 3months,6months and 12 months of AVF after the first and second PTA in 30 patients who were accepted two times PTA among the 87 patients.Log-Rank test was used to compare whether there is statistical difference in primary patency rate of AVF between the first and second PTA.Result :1.117 times PTA guided by ultrasound were performed in 87 patients,with115 successes and 2 failures.The success rate was 98.29%.2.The primary patency rate of AVF after the first PTA in 87 patients at3 months,6months and 12 months were 94.05%,80.95% and 56.63%.The median patency time was 12.00±1.25 months.3.The Kaplan-Meier and Log-Rank methods showed that patient age,diabetes and the use time of AVF may be the the influencing factors of the primary patency rate of AVF after the first PTA(P <0.05).4.The Cox multivariate regression analysis showed that patient age and diabetes may be the influencing factors of the primary patency rate of AVF after the first PTA(P <0.05).5.The primary patency rate of AVF after the first and second PTA in 30 patients at 3months,6months and 12 months were respectively 91.30% and93.33%,82.50% and 83.20%,61.10% and 58.90%.The median patency time were respectively 12±0.66 months and 13±1.02 months.6.There was no statistically significance in the primary patency rate of AVF at 3months,6months and 12 months between the first and second PTA(P<0.05).conclusion:1.PTA guided by Ultrasound is a effective method for the treatment of AVF stenosis.2.Patient age and diabetes may be the influencing factors of the primary patency rate of AVF after the first PTA.3.There is no difference in the primary patency rate between the first and repeated PTA guided by ultrasound.