Angioplastia ecoguiada de fístula arteriovenosa para hemodiálise: experiência inicial de um centro
Ultrasound-guided angioplasty of arteriovenous fistula for hemodialysis: initial experience of a single center
Claudia Guimarães Agle; Fábio Luis Barbosa Andrade; Ana Clarice de Carvalho Bacelar; Giovana Pires de Sousa Bonfim; Eduardo Castro de Oliveira; José Siqueira de Araujo Filho
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Abstract
Chronic Kidney Disease is a growing public health concern and arteriovenous fistulas (AVFs) are the preferred type of vascular access for hemodialysis, but venous stenosis can impair their function. Angioplasty is the first-line treatment, but availability is limited on the public health care system. This retrospective study evaluated the feasibility and early outcomes of ultrasound-guided AVF angioplasty performed at a referral center in 2024. Nine patients were recruited and followed for 3 months. Outcomes included technical success, blood flow, venous diameter, complications, and patency. Technical success was achieved in 77.8% of cases, with increased blood flow and venous diameter. Complications occurred in 66.6%, the majority minor hematomas, although two patients developed acute thrombosis. The technique was feasible and improved hemodynamic parameters, although with a non-negligible complication rate.
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References
1 Nerbass FB, Lima HN, Moura-Neto JA, Lugon JR, Sesso R. Censo Brasileiro de Diálise 2022. Braz J Nephrol. 2023;46(2):1-8.
2 Beathard GA. Successful treatment of the chronically thrombosed dialysis access graft: resuscitation of dead grafts. Semin Dial. 2006;19(5):417-20.
3 Franco RP, Riella MC, Chula DC, Alcântara MT, Nascimento MM. Safety and efficacy of arteriovenous fistula angioplasties performed by nephrologists: report from a Brazilian interventional nephrology center. J Bras Nefrol. 2022;44(2):196-203.
4 Harduin LO, Barroso TA, Guerra JB, et al. Diretrizes sobre acesso vascular para hemodiálise da Sociedade Brasileira de Angiologia e de Cirurgia Vascular. J Vasc Bras. 2023;22:e20230052.
5 Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(5, Suppl 1):S31-4.
6 Abbadie F, Kosmadakis G, Aguilera D, Piraud A. Duplex ultrasound-guided angioplasty of hemodialysis vascular access. J Vasc Surg. 2025;78(5):1292-1301.e3.
7 Kazandjian C, Petit V, Favier C, Terriat B, Steinmetz E. Ultrasound-guided angioplasty of arteriovenous fistulas for hemodialysis: benefits and limitations. Ann Vasc Surg. 2019;58:32-7.
8 Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access. 2019 Update. Am J Kidney Dis. 2020;75(4, Suppl 2):S1-164.
9 Harduin LO, Barroso TA, Guerra JB, et al. Efficacy and safety of paclitaxel drug-coated balloon angioplasty for stenosis of hemodialysis vascular access: 6-month results from a Brazilian multicenter prospective study. J Vasc Bras. 2025;24:e20240103.
10 DerDerian T, Hingorani A, Boniviscage P, Carollo A, Ascher E. Acute complications after balloon-assisted maturation. Ann Vasc Surg. 2014;28(5):1275-9.
11 Dolmatch BL, Gunn AJ, Arslan B, et al. Society of Interventional Radiology practice guidance document on percutaneous arteriovenous fistulae for dialysis access. J Vasc Interv Radiol. 2025;36(12):1945-57.e2.
12 Higgins MCSS, Diamond M, Mauro DM, et al. ACR Appropriateness Criteria® dialysis fistula malfunction. J Am Coll Radiol. 2023;20(11S):S382-412.
Submitted date:
02/16/2026
Accepted date:
06/09/2026
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