Arteriovenous fistulas (AVFs) serve as the preferred vascular access for end-stage renal disease (ESRD) patients undergoing hemodialysis. Among AVFs, upper-arm brachiocephalic AVFs are favored due to their superior maturation rate, extended patency duration, and minimal complications. Nevertheless, these fistulas often encounter cephalic arch stenosis, necessitating recurrent angioplasties.
Study Design: Retrospective cohort study
Study Period: January 2020 – December 2021.
Setting: Interventional Radiology Department, Sultan Qaboos University Hospital (SQUH)
Inclusion Criteria: Patients with right or left brachiocephalic fistulas who underwent at least two subsequent angioplasties to address cephalic arch stenosis.
Exclusion Criteria:
- Patients with AVFs other than brachiocephalic fistula
- Patients with brachiocephalic fistula without stenosis on angiography.
- Cephalic vein stenosis other than the cephalic arch
Patient data were reviewed from the Radiology Information System (RIS) at SQUH. Data assessment was performed by an interventional radiologist with over 15 years of experience. The number of days between the first and second angioplasty was recorded to calculate the average patency rate. Immediate outcomes were assessed using interventional radiology
Outcome Classification: Angioplasty outcomes were categorized as:
No residual stenosis = Successful
<30% residual stenosis = Partially successful
>30% residual stenosis = Failed
Complications such as rupture and bleeding were documented, with a focus on the cephalic arch as the primary site for stenosis. Patient demographics, including age and gender, were also collected.
Statistical analysis was conducted using SPSS software 26, encompassing procedure-related data such as outcomes, complications, and the time intervals between two angioplasties. Bar and pie charts were employed for visual representation. The mean interval between interventions was calculated to estimate the average duration of AVF patency.