Abstract:  Objective To investigate the effect of DSA-guided PTA on serum sVCAM-1, apelin-13 and rehabilitation in hemodialysis patients with AVF stenosis.  Methods  A total of 120 patients who received hemodialysis and had AVF stenosis during July 2020 to February 2024 at the First People's Hospital of Qujing City, Yunnan Province were retrospectively analyzed. According to the treatment methods, the 120 patients were divided into a control group (undergoing AVF resection and reconstruction surgery) and an experimental group (implementing PTA therapy), with 60 patients in each group. AVF function, serum sVCAM-1 and apelin-13 levels, surgical success, comfort level, and complications were compared between the two groups.  Results  Before treatment, the internal fistula diameter, dialysis blood flow and internal fistula blood flow were similar in the two groups (t=0.237, 0.477 and 0.157 respectively; P=0.813, 0.634 and 0.875 respectively); after treatment, the internal fistula diameter, dialysis blood flow and internal fistula blood flow were improved in both groups (control group: t=2.864, 3.691 and 5.803 respectively; P＜0.001. experimental group: t=6.043, 6.594 and 9.043 respectively; P＜0.001). The improvement of internal fistula diameter, dialysis blood flow and internal fistula blood flow were better in experimental group than in control group (t=2.681, 3.522 and 3.481 respectively; P＜0.001). Before treatment, serum levels of sVCAM-1 and apelin-13 were similar in the two groups (t=0.354, and 0.656; P=0.724 and 0.513); after treatment, serum sVCAM-1 decreased and serum apelin-13 increased in the two groups (control group: t=3.753 and 2.284, P＜0.05. experimental group: t=7.507 and 5.319, P＜0.05). The decrease of serum sVCAM-1 and increase of serum apelin-13 were more in experimental group than in control group (t=3.841 and 2.389; P＜0.05). There were no differences in success rate of surgical technique (χ²=0.209, P=0.648) and clinical success rate (χ²=1.008, P=0.315) between experimental group and control group. The incidence of complications was lower in experimental group than in control group (1.67% vs. 16.67%; χ²=8.107, P=0.004).  Conclusion  PTA under ultrasound shows better therapeutic effect and safety in the treatment of AVF stenosis in hemodialysis patients. By reducing serum sVCAM-1, increasing serum apelin-13 and improvement of vascular function and endothelial cell function, patients’ comfort and rehabilitation are enhanced.

Key words: Percutaneous transluminal angioplasty, Hemodialysis, AVF stenosis, sVCAM-1, Apelin-13, Rehabilitation effect