Failing arteriovenous access: endovascular option
Abdulaziz Z AlGaby, Alaa A.H Marzouk, Khaled Shawky, Mohamed H Abdelmawla

The Egyptian Journal of Surgery 2019 38(2):231-238

Objective Hemodialysis access is considered the lifeline for patients with end-stage renal disease. So, maintaining it is extremely crucial for these patients. This study is designed to show the rule of percutaneous intervention to maintain their access. Patients and methods It is a prospective study conducted in Beni Suef University hospital from June 2016 to January 2018 on 20 patients with failing arteriovenous (AV) access. They were subjected to endovascular ballooning to relieve stenosis of their access and/or outflow vein. Efficacy, represented by technical success and clinical success, and complications of the procedure were assessed. Results The study revealed that 80% of the patients had technical success. However, 60% of the patients had their symptoms improved and succeeded to maintain their dialysis access. No major complications were attributed to the intervention. There was a strong association between lesions of total occlusion and technical failure. Conclusion Percutaneous treatment of dysfunctional or failing autologous dialysis fistulas can successfully and safely extend functional lifespan. Attention should be paid to lesions of total occlusion as they are difficult to cross and subsequently balloon dilatation.