Abstract: Object To retrospectively study the clinical and radiological features of stenosis in autologous arteriovenous fistula (AVF), and the relationship between clinical features and stenosis site in order to improve the autologous AVF surgery. Method We retrospectively analyzed the clinical and radiological data of the patients who were examined with angiography due to AVF stenosis in the Third Hospital of Hebei Medical University during the period from Jan. 1st, 2011 to Dec. 31st, 2014. Patients had complete disease history and radiological records, and their autologous AVFs adopted end-to-side anastomosis technique in forearms. Two
nephrologists responsible for construction and care of AVFs reviewed the radiological images, identified the stenosis type, analyzed their clinical characteristics, and performed statistical analyses. Result A total of 64 patients having 81 angiography examinations were involved in this study, including 39 angiography examinations for 29 females and 42 angiography examinations for 35 males. Their average age was 55.52±1.71 (26- 80) years old, and their average dialysis duration was 31.22±3.67 months. Twenty-seven cases (having 40 angiography examinations) were found to have defined stenosis at arterial site, including artery stenosis proximal to anastomosis site 23 cases (10 cases had stenosis proximal to anastomosis site combined with partial vein stenosis, and 13 cases had stenosis proximal to anastomosis site combined with a long length of vein stenosis). Two cases had distal artery stenosis, and two cases had artery stenosis proximal and distal to the anastomosis site. The average maturation period of the AFVs was 59.94±4.36 days in patients with stenosis, and was
37.83±3.59 days in patients without stenosis (t=3.918, P＜0.001). The average period for blood access of the AVFs was 27.12±5.45 weeks in patients with stenosis, and was 129.44±19.77 weeks in patients without stenosis (t=-4.990, P＜0.001). Conclusion Artery stenosis at the anastomosis site may lead to a prolonged mature period of the AVFs, and a shorter period for blood access due to early failure of the AFVs. Inappropriate surgical manipulation at the anastomosis site during the surgery may be the cause of the artery stenosis.

Key words: Autogenous arteriovenous fistula, Stenosis, Maturation, Fistula dysfunction