Abstract: Objective To investigate the effect of artery-to-fistula diameter ratio of the arteriovenous fistula (AVF) on vascular access patency in patients after percutaneous transluminal angioplasty (PTA) for one year.  Methods A total of 70 patients with maintenance hemodialysis and met the requirements of the study were selected as the study subjects. They were followed up for 12 months. When the patients needed to treat with PTA or AVF reconstruction due to re-occlusion, follow-up was terminated. According to the primary patency time, they were divided into two groups: group A (n=24, primary patency time ＜12 months) and group B (n=46, primary patency time ≥12 months) to observe their primary patency after PTA. Clinical characteristics of the two groups were collected and compared.  Results  The average age of group A was 72.33 years (range 65.22～79.44), significantly higher than that of group B (58.00 years, range 51.19～64.81). However, the artery-to-fistula diameter ratio of AVF were significantly higher in group A than in group B (t=4.251, P＜0.001). Logistic regression showed that a higher artery-to-fistula diameter ratio of AVF was an independent predictor of restenosis within one year after PTA (OR=0.000, 95% CI: 0.000～0.033, P=0.002). ROC curve analysis showed that the area under the curve (AUC) of the artery-to-fistula diameter ratio of the AVF was 0.788 (95% CI: 0.667～0.909, P＜0.05), and the cut-off value of the artery-to-fistula diameter ratio of the AVF was 0.752. The Youden index was 0.576, the sensitivity was 75.0%, and the specificity was 82.6%.  Conclusion Patients with a higher artery-to-fistula diameter ratio of the AVF after PTA have a higher risk of re-fistula failure within one year.

Key words: Hemodialysis, Arteriovenous fistula, Artery-to-fistula diameter ratio, Percutaneous transluminal angioplasty