Analysis of Risk Factors for Patency Rate After Ultrasound-Guided PTA for AVF Stenosis

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Nephrology

Background:

• Arteriovenous fistula (AVF) stenosis is a common complication after percutaneous transluminal angioplasty (PTA).
• Restenosis post-PTA significantly impacts AVF function and patient outcomes.
• Predicting restenosis is essential for proactive management and improved treatment strategies.

Purpose of the Study:

• To identify independent risk factors for restenosis following ultrasound-guided PTA of AVF stenosis.
• To develop and validate a predictive model (nomogram) for estimating restenosis risk.
• To assess the clinical utility of the developed predictive model.

Main Methods:

• A cohort of 100 patients undergoing PTA for AVF stenosis was retrospectively analyzed.
• Patients were classified into restenosis (n=39) and non-restenosis (n=61) groups based on 12-month follow-up.
• Multivariable logistic regression, nomogram construction, ROC analysis, calibration curves, and decision curve analysis (DCA) were employed.

Main Results:

• Independent risk factors identified: diabetes, type I stenosis, severe AVF stenosis, AVF functional time < 6 months, vascular calcification, and elevated High-Sensitivity C-Reactive Protein (all p < 0.05).
• The predictive model exhibited good discrimination (AUC = 0.820) and calibration (p = 0.3575).
• Decision curve analysis confirmed the clinical utility of the model.

Conclusions:

• Several key clinical and laboratory factors significantly predict restenosis after PTA for AVF stenosis.
• The developed nomogram is a reliable tool for predicting restenosis risk, aiding in clinical decision-making.
• This predictive model can help personalize treatment strategies and improve long-term AVF patency.