Application Value Of Balloon Dilation Guided By Color Doppler Ultrasound In Vascular Access Stenosis

Objective: To compare the efficacy between balloon dilatation guided by color ultrasound and surgical reconstruction in the treatment of hemodialysis autogenous fistula anastomotic proximal stenosis(within 2 cm from the anastomosis).Methods: The clinical data of 69 patients with arteriovenous fistula anastomotic proximal stenosis were retrospectively analyzed in the Third Affiliated Hospital of Bengbu Medical College.The patients were divided into the group A(36 cases treated with percutaneous transluminal angioplasty(PTA)and group B(33 cases treated with revascularization surgery).The patency rates in two groups at 1,3 and 6 months of after treatment were evaluated.The differences in blood flow and vascular diameter between the two groups before and 1 month after surgery also were compared.Results:(1)The dialysis time of group A was(4.11±3.06)years.There were 21 males and15 females.The clinical success rate was 97% and the technical success rate was 100%.In group B,the dialysis time was(3.85±2.81)years,including 22 males and 11 females.The clinical success rate was 94% and the technical success rate was 100%.No statistical difference was found between two groups of general data contrast(P > 0.05).(2)There was no statistical difference in patency rate between group A and group B at 1,3 and 6 months after surgery(group A vs.group B,94.44% vs.90.91%,88.89% vs.84.85%,83.33% vs.75.76%,P > 0.05).(3)There was no statistical significance in the incidence of complications between the two groups(Group A vs.Group B,8.33% vs.6.06%,P > 0.05).(4)There was no statistical significance in the intravascular diameter of internal fistula stenosis and brachial artery blood flow between two groups before operation and after 1 month of operation(P>0.05).The blood vessel diameter and blood flow in two groups after operation were significantly greater than those before operation(P<0.01).Conclusions: Balloon dilatation guided by color ultrasonography has the same efficacy as surgery in the treatment of arteriovenous fistula anastomotic proximal stenosis,and the operation safety is high.The balloon dilatation guided by color ultrasound is simple,the patients can be dialysed after operation,the vascular resources can be preserved,so which can be recommended as the preferred treatment for arteriovenous fistula anastomotic proximal stenosis.