关键词: 血液透析通路狭窄, 球囊扩张, 球囊压力

Abstract: 【Abstract】Objective To investigate the balloon pressure required during percutaneous transluminal angioplasty (PTA) in the treatment of hemodialysis access stenosis at different locations. Methods Patients with hemodialysis access stenosis and received PTA in Jinshan Hemodialysis Access Center, the First Affiliated Hospital of Chongqing Medical University during April 2020 to September 2020 were enrolled in this study. Demographic and surgical data were collected. The balloon pressure used at different positions was analyzed. Results A total of 259 patients (102 males and 157 females) were enrolled. They had 300 stenosis lesions
including 242 in arteriovenous fistulas and 58 in arteriovenous grafts. The clinical success rate was 100% (300/300), the surgical success rate was 98.7% (296/300), and the incidence of surgical complications was 7.333%, including 13 cases of hematoma and 9 cases of vascular rupture. The total mean balloon pressure was 16.693±6.237 atm, and 58.34% (175/300) of the patients used the pressure of >14 atm for full dilation of the lesions. There was no significant difference in pressure required for full dilation between arteriovenous fistulas and arteriovenous grafts, and among different lesion sites in arteriovenous grafts. However, the
mean balloon pressure for lesions in juxta-anastomotic sites of arteriovenous fistulas was 18.467±5.706 atm, significantly higher than that for lesions in puncture area (t=2.070, P=0.040) and outflow vein (t=4.969, P<0.001). Conclusion The hemodialysis access stenosis requires higher pressure during PTA to achieve full dilation, and the pressure required at different lesion sites is different. According to these characteristics, appropriate selection of balloon makes the endovascular intervention economical and efficient.

Key words: Hemodialysis access stenosis, Percutaneous transluminal angioplasty, Balloon pressure