Abstract: Objective  To investigate the therapeutic effect of ultrasound-guided percutaneous transluminal angioplasty (PTA) for the treatment of thrombosis in autogenous arteriovenous fistula (AVF).  Method, Patients having thrombosis in AVF and treated with ultrasound-guided PTA or open surgery in the Nephrology Department of Taizhou Hospital of Zhejiang Province during January 2016 to November 2020 were retrospectively analyzed. They were followed up for 12 months. Their clinical data, operation-related conditions and complications were recorded. The primary patency rates and secondary patency rates after 3, 6, 9 and 12 months were observed.  Result  A total of 125 patients with thrombosis in AVF were included in this study, in which 46 patients received ultrasound-guided PTA (PTA group) and 79 patients underwent thrombectomy (surgery group). There were no significant differences in preoperative thrombosis time (t=0.315, P=0.753), anesthesia mode (χ2=2.896, P=0.102), operation time (t=0.183, P=0.885) and success rate (χ2＜0.001, P=1.000) between the two groups. The medical expenses were 14,594.17±4,723.79 yuan in PTA group, significantly higher than that of 6,404.76±5,303.15 yuan in surgery group (t=8.660, P<0.001). There were no significant differences in the primary patency rates after 3 months and 6 months between PTA group and surgery group (after 3 months: 95.65%  vs. 91.14%, χ2=2.016, P=0.156; after 6 months: 78.26% vs. 84.81%, χ2=0.352, P=0.553). The primary patency rates after 9 months and 12 months were significantly lower in PTA group than in surgery group (after 9 months: 63.04% vs. 83.54%, χ2=5.787, P=0.016; after 12 months: 58.70% vs. 82.28%, χ2=7.224, P=0.007). The secondary patency rate after 12 months was 97.8% in PTA group and 96.2% in operation group (χ2=0.186, P=0.667).  Conclusion   In the treatment of patients with thrombosis in AVF, ultrasound-guided PTA is a safe and effective measure, having advantages of prolonged hemodialysis access and saving vascular resources for hemodialysis patients.

Key words: Autogenous arteriovenous fistula, Thrombosis, Percutaneous transluminal angioplasty, Open surgery