Abstract: 【Abstract】Objective To investigate the surgical effect, long-term patency rate and economic benefit of PTA combined with open surgery for the treatment of type I combined with type II stenosis in arteriovenous fistulas in upper limbs. Methods A total of 40 patients having type I combined with type II stenosis in arteriovenous fistula were recruited in this study. They were divided into group A (PTA combined with open surgery), group B (ultrasound guided PTA), and group C (DSA guided PTA). Success rate of operation, changes of vessel diameter and blood flow after surgery, long-term patency rate, and medical expenses were compared
among the 3 groups. Results The success rate of operation in group A was better than that in group B and group C (X2=8.556 and 4.609; P=0.010 and 0.052). Post-operative vessel diameter in group A was bigger than that in group B and group C (t=2.605 and 3.676; P=0.044 and 0.003). Post-operative brachial blood flow in group A was greater than that in group B and group C (t=2.764 and 2.482; P=0.030 and 0.058). Medical expenses of group B was lower than that of group A and group C (t=3.130 and -3.036; P=0.012 and 0.015). The long-term patency rate of group A was better than that of group B and group C (P=0.730). Conclusions PTA combined with open surgery to treat type I combined with type II stenosis in arteriovenous fistula has the advantages of higher success rate of operation, greater long-term patency rate, wider post-operative blood vessel diameter and more brachial artery blood flow, but has to use more vascular resources than ultrasound guided PTA and DSA guided PTA. Moreover, patients treated with PTA combined with open surgery have to pay more medical fees than those treated with ultrasound guided PTA.

Key words: Arteriovenous fistula, Type I combined with type II stenosis, Surgical method