FEMORAL ARTERY: AN ALTERNATIVE CANNULATION LOCALIZATION IN THE ANGIOGRAPHIC TREATMENT OF DYSFUNCTIONAL ARTERIOVENOUS FISTULAS. SINGLE-CENTER EXPERIENCE.

Abstract

Background: Although endovascular interventions are the most commonly used treatment modalities in the treatment of dysfunctional AVFs, there is no consensus on the optimal puncture site. In this retrospective single-center study, we present the short-term clinical success rates and complications of our interventions for dysfunctional AVFs via the femoral artery. Material Methods: 29 hemodialysis patients who were diagnosed with AVF dysfunction between January 2016 and December 2019 and therefore underwent percutaneous transluminal angioplasty (PTA) were included in this study. All PTAs were performed by the same experienced interventional cardiologist. Demographic, clinical data of the patients, and data on primary patency and procedural complications used were obtained from the hospital database and electronic records of the patient's own hemodialysis center. Detection of "thrill" after the procedure, successful cannulation, and adequate hemodialysis immediately after the treatment was considered a clinical success. Results A total of 29 hemodialysis patients underwent PTA due to AVF dysfunction. The median age of the patients was 61 (IQR 55.0-68.0) and 72.4% were male. 41% of patients were diabetic. The Median AVF age was 44.0 (24.0-92.0) months. Juxtaanastomotic (48.3%) and efferent venous stenosis (37.9%) were the main causes of AVF dysfunction. Paclitaxel-released balloon angioplasty was performed on 27 patients. The clinical success rate of the procedure was 93.1%. Two patients developed a local hematoma at the femoral artery puncture site; no other major or minor complications were detected. Conclusion: PTA via the femoral artery is an effective and safe treatment modality for AVF dysfunctions.