Articles Vol. 67 No. 5 25/05/2026

EARLY OUTCOMES OF ARTERIOVENOUS FISTULA INTERVENTION AT FRIENDSHIP HOSPITAL

Do Ngoc Anh1,2, Tran Minh Thoai3,4
1 Faculty of Pharmacology and Clinical Pharmacy, Hanoi University of Pharmacy
2 Khoa Dược lý - Dược lâm sàng, Trường Đại học Dược Hà Nội
3 Faculty of Interventional Cardiology, Friendship Hospital
4 Khoa Tim mạch can thiệp, Bệnh viện Hữu Nghị
DOI: 10.52163/yhc.v67i5.5145
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Keywords
Arteriovenous fistula stenosis, endovascular intervention, balloon angioplasty, hemodialysis.
Abstract

Objectives: To describe clinical and lesional characteristics and evaluate early outcomes (after 1 month) of endovascular intervention for arteriovenous access stenosis in hemodialysis patients. 

Subjects and methods: A descriptive, retrospective and prospective study on 47 end-stage renal disease patients on hemodialysis with significant access stenosis (> 50%) who underwent endovascular intervention at Friendship Hospital from 3/2023 to 12/2024.

Results: The mean age of the patients was 71.9 ± 10.9 years, with 87.2% males. Hypertension (76.6%) and diabetes (53.2%) were common comorbidities. Radiocephalic arteriovenous fistula accounted for 76.6%. The most common stenosis location was the juxta-anastomotic area (51.1%), with a mean stenosis degree of 81.7 ± 10.3%, and lesion length of 42 ± 14 mm. Mean access flow before intervention was 350.7 ± 220.3 ml/min. Technical and clinical success rates were 100%. Post-intervention access flow improved significantly (654.7 ± 320.6 ml/min, p < 0.001). Minor complications included access site bleeding (6.4%) and venous spasm (8.5%). The 1-month restenosis rate was 4.3%. 

Conclusion: Endovascular intervention is a safe and highly effective method for treating arteriovenous access stenosis, especially in elderly patients, helping to restore and maintain hemodialysis functionality.

References
[1]
Đinh Huỳnh Linh và cộng sự. Đánh giá kết quả sớm can thiệp nội mạch điều trị hẹp/tắc thông động tĩnh mạch ở Viện Tim mạch Việt Nam. Tạp chí Tim mạch học Việt Nam, 2019, 87: 21-27. Google Scholar
[2]
Brahmbhatt A, Remuzzi A, Franzoni M, Misra S. The molecular mechanisms of hemodialysis vascular access failure. Kidney Int, 2016, 89 (2): 303-316. doi: 10.1016/j.kint.2015.12.019. Google Scholar
[3]
KDOQI, National Kidney Foundation. KDOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis, 2006, 47 (5 Suppl 3): S11-S145. doi: 10.1053/j.ajkd.2006.03.010. Google Scholar
[4]
Viecelli A.K et al. Report of the Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) consensus workshop on establishing a core outcome measure for hemodialysis vascular access. Am J Kidney Dis, 2018, 71 (5): 690-700. doi: 10.1053/j.ajkd.2017.12.003. Google Scholar
[5]
Schwab S.J, Oliver M.J, Suhocki P, McCann R. Hemodialysis arteriovenous access: detection of stenosis and response to treatment by vascular access blood flow. Kidney Int.,2001, 59 (1): 358-362. doi: 10.1046/j.1523-1755.2001.00498.x. Google Scholar
[6]
Lotfi U, Mostafa H. Evaluation of the endovascular salvage outcome for dysfunctional arteriovenous fistula for hemodialysis according to the site of the lesion. J Cardiol & Cardiovasc Ther, 2017, 2 (5): 1-8. doi: 10.19080/JOCCT.2017.02.555596 Google Scholar
[7]
Beathard G.A. Percutaneous transvenous angioplasty in the treatment of vascular access stenosis. Kidney Int, 1992, 42 (6): 1390-1397. doi: 10.1038/ki.1992.431. Google Scholar
[8]
Aktas A, Bozkurt A, Aktas H et al. Percutaneous transluminal balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas: technical success and analysis of factors affecting postprocedural fistula patency. Diagn Interv Radiol, 2015, 21 (2): 160-166. doi: 10.5152/dir.2014.14348. Google Scholar