EFFICACY OF FISTULA SALVAGE ANGIOPLASTY IN PROLONGING AV FISTULA FUNCTIONALITY IN HEMO DIALYSIS PATIENT

Abstract

Background: Arteriovenous (AV) fistulas are the access of choice for hemodialysis but often fail secondary to thrombosis or stenosis. Percutaneous transluminal angioplasty (PTA) is a less invasive procedure designed to restore fistula function.

Objective: To analyze the clinical efficacy of PTA in salvaging nonfunctioning AV fistulas and ensuring long-term patency in hemodialysis patients.

Methods: A prospective observational study was performed at Saveetha Medical College and Hospital among 44 adult patients with chronic kidney disease (CKD) on hemodialysis with failed AV fistulas. PTA was done in all of them and they were followed up for 6 months to determine patency, complications, dialysis function, and satisfaction.

Results: PTA was technically successful in 100% of patients, with restoration of thrill immediately. At 3 and 6 months, the primary patency rates were 81.8% and 72.7%, respectively. Secondary patency was preserved in 95.5% of the cases, and 18.2% of the cases needed re-intervention. Hemodialysis could be continued with the salvaged AVFs in 90.9% of the patients. Minor complications were seen in 25% of the cases, and 86.4% of the patients were highly satisfied.

Conclusion:PTA is a safe and very effective technique for salvaging AV fistulas that are declining in hemodialysis patients. It allows for ongoing dialysis at the native access site, reduces central venous catheter dependency, and leads to high patient satisfaction. Ongoing monitoring is advocated to preserve long-term fistula function.