Factors influencing primary patency time of percutaneous transluminal balloon angioplasty for hemodialysis arteriovenous grafts

Abstract

Objective: To investigate the factors affecting primary patency time in arteriovenous graft (AVG) patients receiving percutaneous transluminal balloon angioplasty (PTA). Methods: Hemodialysis patients who underwent AVG placement at the First Affiliated Hospital of Chongqing Medical University between February 2018 and December 2021 were included. The factors including age, gender, total duration of AVG use, site of stenosis, degree of stenosis, length of stenosis, residual stenosis, and presence of thrombosis were analyzed, and influencing factors of primary patency time in AVG were determined using a multiple linear regression model. Results: A total of 101 patients who underwent 331 PTA treatments were enrolled, including 35 males and 66 females. The median age of patients undergoing PTA for the first time was 61 (51, 68) years, and the primary patency time after PTA was 5 (3, 10) months. The patients were followed up for (38.5±15.3) months. Multivariable linear regression analysis revealed that severe stenosis at the venous anastomosis and reflux veins (β=-2.773, 95%CI:-5.440--0.105, P=0.042), female (β=-2.247, 95%CI:-3.853--0.642, P=0.006), and previous multiple PTA treatments (β=-0.516, 95%CI:-0.978--0.054, P=0.029) were risk factors for a shorter primary patency time after PTA. Conclusion: Severity of stenosis at the venous anastomosis and reflux veins of the AVG, female, and a history of multiple previous PTA treatments are associated with a shorter primary patency time in AVG patients.