[Endovascular angioplasty of native arteriovenous fistulas using ultrasound navigation]

Complications developing on the part of a vascular access appear to be one of the main challenges in treatment of patients undergoing programmed hemodialysis. In such patients, every effort should always be made to keep at a maximum the duration of the functioning access. Ultrasound navigation while performing endovascular correction of vascular access complications possesses a series of advantages over the conventional X-ray imaging.

The purpose of this study was to examine the advantages of ultrasound navigation during endovascular angioplasty of arteriovenous fistulas created for programmed hemodialysis.

We carried out a retrospective analysis of treating 27 patients undergoing renal replacement therapy and admitted to the Nizhnevartovsk Regional Clinical Hospital with dysfunction of the permanent vascular access. Between October 2021 and February 2023, in order to correct the arteriovenous fistula they were subjected to endovascular operations using ultrasound navigation. The 27 patients endured a total of 33 procedures of endovascular correction of the access under ultrasound navigation.

The technical success rate was 95.8%. There were no events of vascular access dysfunction during a 17-month follow-up period. Freedom from reinterventions at 3, 6 and 12 months amounted to 92.6, 82.3 and 79.3%, respectively.

The method of ultrasound-based navigation when performing endovascular operations of correcting early and late failure of arteriovenous fistulas in patients on programmed hemodialysis demonstrated high efficacy and safety.