Patient and Lesion Characteristics Associated with 12-Month Clinical Maturation after Angioplasty of Immature Autogenous Arteriovenous Dialysis Fistulae.
Journal
Journal of vascular and interventional radiology : JVIR
Journal Volume
37
Journal Issue
7
Pages
108796
ISSN
1535-7732
Date Issued
2026-04-12
Author(s)
Lien, Cheng-Wei
Hsieh, Ming-Chieng
Hsu, Ru-Yin
Luo, Chien-Ming
Abstract
Purpose: To assess clinical maturation rates after assisted percutaneous transluminal angioplasty (PTA) of immature autogenous arteriovenous fistulae (AVFs) and to identify patient and lesion characteristics associated with maturation.
Materials and methods: Consecutive patients with immature AVFs undergoing PTA (July 2018 to December 2022) were retrospectively included. Clinical maturation (primary endpoint) was defined as successful 2-needle cannulation in ≥75% of sessions over 4 consecutive weeks within 12 months after PTA, assessed from dialysis records at 3-month intervals. Patency outcomes were prospectively recorded per Society of Interventional Radiology (SIR) standards. Multivariable logistic regression adjusted for age, Katz Activities of Daily Living disability, occlusion, number of stenoses, arterial stenosis, and reference vessel diameter; subgroup analyses were prespecified by age (>75 vs ≤75 years) and number of stenoses (single vs multiple).
Results: Among 156 patients (mean age, 65 years [SD ± 13]; male, 58%), technical success was 99% (154/156). Cumulative clinical maturation rates were 58%, 66%, 74%, and 76% at 3, 6, 9, and 12 months, respectively. Twelve-month primary, assisted primary, and secondary patency rates were 49%, 80%, and 87%, respectively. In the multivariable model, age of >75 years (odds ratio [OR], 4.90; 95% CI, 1.50-15.06; P = .01), severe disability (OR, 3.12; 95% CI, 1.12-8.69; P = .03), and multiple stenoses (OR, 2.89; 95% CI, 1.16-7.20; P = .02) independently predicted nonmaturation.
Conclusions: Treatment of immature AVFs with PTA can enable successful hemodialysis use in a substantial proportion of patients, although angiographic patency does not always translate into consistent usability. Both patient condition (age and disability) and lesion characteristics (number of stenoses) were independently associated with clinical maturation after PTA.
Publisher
Society of Cardiovascular and Interventional Radiology
Type
journal article