International urology and nephrology · 2025
Analysis of primary patency rate and influencing factors of ultrasound-guided percutaneous transluminal angioplasty for the treatment of arteriovenous fistula dysfunction.
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Wu You
Аннотация
BACKGROUND: Ultrasound-guided percutaneous transluminal angioplasty (UG-PTA) has become the preferred endovascular intervention for arteriovenous fistula dysfunction. However, long-term patency rates remain variable, and identifying key factors affecting outcomes is crucial for clinical decision-making.
METHODS: This retrospective study analyzed 173 patients who underwent UG-PTA for arteriovenous fistula dysfunction at Xuzhou Central Hospital between August 2018 and August 2022. Kaplan-Meier survival analysis was used to assess primary patency rates, and Cox proportional hazards modeling identified independent risk factors affecting patency duration.
RESULTS: The median primary patency time after initial PTA was 33.00 months (95% CI 24.76-41.25). The primary patency rates were 93.1% at 3 months, 83.2% at 6 months, 68.9% at 12 months, 55.0% at 24 months, 45.9% at 36 months, and 30.9% at 48 months. The mean secondary patency time was 56.30 months (95% CI 53.18-59.42), and the secondary patency rates were 92.3% at 12 months, 90.2% at 24 months, 85.0% at 36 months, and 82.3% at 48 months. Native arteriovenous fistulas (AVFs) showed significantly longer patency than grafts (AVGs) (36 vs 6 months, p < 0.001). Multivariate analysis identified the degree of feeding artery calcification, lesion location, and access type (AVF vs. AVG) as independent factors affecting primary patency. With regular UG-PTA surveillance, secondary patency remained 82.3% at 48 months.
CONCLUSION: Vascular calcification burden and access type are key determinants of UG-PTA outcomes. High-risk patients (e.g., those with AVGs or significant feeding artery calcification) may benefit from intensified surveillance and individualized intervention protocols.
METHODS: This retrospective study analyzed 173 patients who underwent UG-PTA for arteriovenous fistula dysfunction at Xuzhou Central Hospital between August 2018 and August 2022. Kaplan-Meier survival analysis was used to assess primary patency rates, and Cox proportional hazards modeling identified independent risk factors affecting patency duration.
RESULTS: The median primary patency time after initial PTA was 33.00 months (95% CI 24.76-41.25). The primary patency rates were 93.1% at 3 months, 83.2% at 6 months, 68.9% at 12 months, 55.0% at 24 months, 45.9% at 36 months, and 30.9% at 48 months. The mean secondary patency time was 56.30 months (95% CI 53.18-59.42), and the secondary patency rates were 92.3% at 12 months, 90.2% at 24 months, 85.0% at 36 months, and 82.3% at 48 months. Native arteriovenous fistulas (AVFs) showed significantly longer patency than grafts (AVGs) (36 vs 6 months, p < 0.001). Multivariate analysis identified the degree of feeding artery calcification, lesion location, and access type (AVF vs. AVG) as independent factors affecting primary patency. With regular UG-PTA surveillance, secondary patency remained 82.3% at 48 months.
CONCLUSION: Vascular calcification burden and access type are key determinants of UG-PTA outcomes. High-risk patients (e.g., those with AVGs or significant feeding artery calcification) may benefit from intensified surveillance and individualized intervention protocols.