Effect of the combination of percutaneous transluminal angioplasty and pharmacological thrombolysis on hemodialysis patients

Abstract

Purpose: To examine the efficacy of percutaneous transluminal angioplasty (PTA), combined withpharmacologic thrombolysis (PT) on thrombosis of autologous arteriovenous fistulas (AVFs),inflammatory factors, and β2 microglobulin (β2-MG) levels in hemodialysis patients.Methods: Seventy-eight patients with AVF thrombosis allocated randomly into a control group (CG) received PTA, and a study group (SG) received PTA combined with PT (n = 39 in each). The patency, vascular condition, inflammatory factors, viz, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP)), β2-MG levels, vascular-related factors (VEGF-A and MCP-1), complications, and quality of life were determined.Results: At three and six months after surgery, t SG exhibited a higher vascular patency than CG (p <0.05). Serum levels of IL-6, hs-CRP, β2-MG, VEGF-A, and MCP-1 of t SG were lower than those of CG(p < 0.05). The SG showed higher cross-sectional area, inner diameter at the site of fistula, and better quality of life scores than CG (p < 0.05).Conclusion: The combination of PTA and PT enhances efficacy, increases vascular patency, reduces inflammatory response, lowers the level of β2-MG, and improves quality of life in patients with AVFs without increasing complications. Thus, the combination treatment has potentials for the management of hemodialysis patients.