Predictive value of preoperative ultrasound for restenosis of arteriovenous fistula after percutaneous transluminal angioplasty: a report of 225 cases

Abstract

Objective‍ ‍To explore the value of preoperative ultrasound examination in the prediction of restenosis of arteriovenous fistula (AVF) after percutaneous transluminal angioplasty (PTA) in hemodialysis patients. Methods‍ ‍A case-control trial was conducted on 225 hemodialysis patients who undergoing PTA due to AVF in our hospital January 2023 to May 2024. After 3 months of follow-up, they were divided into a patency group (n=204) and a restenosis group (n=21) according to the occurrence of postoperative restenosis. The preoperative clinical data and ultrasound parameters were compared between the groups. Binary logistic regression analysis was used to identify the independent factors for AVF restenosis after PTA. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of preoperative stenosis length in the prediction of the restenosis after PTA. Results‍ ‍There were significant differences in preoperative internal diameter at the site of stenosis, stenosis length, stenosis number, intimal thickness, and brachial artery flow between the 2 groups (P<0.05). Preoperative stenosis length (OR=1.856, 95%CI: 1.350~2.552, P<0.001) was an independent factor of AVF restenosis in hemodialysis patients after PTA. ROC curve analysis showed that the area under the curve of preoperative stenosis length in predicting restenosis after PTA was 0.868 (95%CI: 0.784~0.953, P<0.001), with a sensibility and specificity of 85.7% and 80.4%, respectively. Conclusion‍ ‍Preoperative stenosis length may be an independent factor for AVF restenosis after PTA in hemodialysis patients.

Keywords

• ‍ultrasound
• length of stenosis
• arteriovenous fistula
• percutaneous transluminal angioplasty
• restenosis