Endovascular Salvage of Dysfunctional Native Haemodialysis Arteriovenous Fistulas: Clinical Outcomes and Predictors of Patency.

Authors

Srinidhi S Hegde, S B Lohitashwa, Harsha Mullusoge Mariappa, Kiron Varghese, M A Srilakshmi, Pankaj Banotra

Published in

Indian heart journal. Oct 19, 2026. Epub Oct 19, 2026.

Abstract

Hypofunctioning haemodialysis arteriovenous fistulas are an important cause of inadequate dialysis, access failure and morbidity in patients with chronic kidney disease (CKD), and timely catheter-based intervention may help restore access function and prolong fistula usability.
To evaluate the efficacy, feasibility, and safety of catheter-based interventional procedures for hypofunctioning haemodialysis fistulas in patients with CKD.
This single-centre, retrospective observational follow up study, enrolled with 100 CKD patients on maintenance haemodialysis with dysfunctional native arteriovenous fistulas who underwent fistulogram and catheter-based intervention.
The mean age was 57.2 ± 12.4 years, 62.0% were male, and hypertension (80.0%) and diabetes mellitus (57.0%) were the major comorbidities. Radio cephalic fistula was the commonest access type (46.0%), and inadequate dialysis was the leading presentation (73.0%). Fistulography showed significant stenosis in 96.0%, with central vein involvement in 43.0% and long-segment lesions in 56.0%. Angioplasty was attempted in 96.0%, achieving technical success in 91.7% of attempted interventions and clinical success in 85.0%. Stenosis and pressure gradient reduced significantly after intervention (both p<0.001). Complications occurred in 13.0%, with no deaths. Primary patency declined from 82.0% at 1 month to 58.0% at 6 months and 38.0% at 12 months. Patency loss was independently predicted by older age, central vein lesions, long lesions, residual stenosis, and absent post-procedure thrill.
Catheter-based endovascular intervention may be an effective fistula-salvage strategy for hypofunctioning haemodialysis arteriovenous fistulas, although long-term patency was influenced by lesion complexity, residual stenosis and restoration of post-procedure thrill.

PMID:
42896784
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

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