Outcomes of Percutaneous Transluminal Angioplasty for Vascular Access Failure in Patients with End-Stage Renal Disease
Keywords:
percutaneous transluminal angioplasty, post-intervention outcome, vascular access failure, duration of vascular access useAbstract
Objective : To investigate the outcomes of percutaneous transluminal angioplasty (PTA) for vascular access failure, the incidence of intra- and post-procedural complications, and the patency of vascular access over a two-year post-procedural period at Queen Sirikit Heart Center of the Northeast.
Methods : A retrospective descriptive study was conducted by reviewing the medical records of outpatients and inpatients with end-stage renal disease (ESRD) who underwent treatment for vascular access failure with percutaneous transluminal angioplasty at the Cardiac Catheterization Unit, Queen Sirikit Heart Center, from January 1 to December 31, 2021, and were followed up for 2 years after treatment.
Result : A total of 170 ESRD patients who underwent treatment for vascular access failure were included in the study. Of these, 106 were male (62.4%), with a mean age of 61.8 ± 11.5 years and a mean body mass index of 22.6 ± 4.2 kg/m². Most patients had comorbid conditions, including hypertension, diabetes mellitus, dyslipidemia, coronary artery disease, and others. A total of 282 PTA procedures were performed, with a technical success rate of 96.1%. Major complications occurred in 2.1% of procedures, most commonly arterial rupture, neurological complications, and heart failure, respectively. Minor complications occurred in 13.8% of procedures, with the most frequent being venous/venous anastomotic rupture, venous intimal dissection, and balloon fragmentation. During the two-year follow-up period, the mean patency time of vascular access after the first PTA was 24.6 ± 26.4 months.
Conclusion : Patients with ESRD who underwent percutaneous transluminal angioplasty for vascular access failure demonstrated a high procedural success rate with a low incidence of intra- and post-procedural complications. The patency of vascular access remained sustained throughout the two-year follow-up period. These findings reflect the effectiveness of percutaneous transluminal angioplasty in managing vascular access failure in this patient population.
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