Effect of Venoplasty on Arteriovenous Fistula Dysfunction on Quick of Blood Values of Hemodialysis Patients

Abstract

Introduction: Percutaneous transluminal angioplasty (PTA) is the gold standard in the management of AVF dysfunction. On the other hand, the management of stenosis with PTA induces an acceleration of neointimal hyperplasia with the occurrence of restenosis. The aim of this study was to assess the increase of quick of blood (Qb) hemodialysis (HD) patients after venoplasty with AVF dysfunction and its patency within 3 months post procedure, and examine the factors associated with venoplasty failure to maintain optimal Qb. Method: This study used a quasi-experimental design, in which all subjects received the treatment under study without a control group, due to ethical issues; because venoplasty is the standard protocol for AVF dysfunction in the place of this study. Qb measurements were made before and after HD, and 3 months thereafter, to evaluate AVF patency. Result: There were 25 cases that included 23 patients with 2 patients had to be re- venoplasty. An increase in Qb averaged 221.3−196.7 mL / min or about 25 mL / min in the 3-month period after venoplasty with significant results (p = 0.044). The location of stenosis in juxta anastomosis has a 14 times greater chance of venoplasty failure (p = 0.037) than stenosis in the area of draining vein or central vein. Diabetes Mellitus (DM) increased the odds of venoplasty failure 12 times greater (p = 0.038) than cases without this comorbid.. Conclusion: This study proves the increase in Qb of hemodialysis patients after venoplasty for AVF dysfunction, and it was found that the location of juxta anastomosis stenosis and the presence of DM are the two main factors that have the potential to increase the chance of venoplasty failure.