Efficacy study of juxta-anastomotic stenosis of the arteriovenous fistula via percutaneous transluminal angioplasty with different accesses to the arteries and veins.

Objective: Juxta-anastomotic stenosis is a leading cause of dysfunction in arteriovenous fistulas (AVFs) for hemodialysis. Percutaneous transluminal angioplasty (PTA) is the primary treatment, but the optimal access approach remains unclear. This study compared the efficacy of arterial versus venous access PTA for treating juxta-anastomotic AVF stenosis and identified risk factors for post-PTA patency loss. Methods: This retrospective study analyzed 267 patients who underwent PTA for AVF stenosis. Patients were divided into vein and artery groups based on access route. The study compared primary patency rates, intervention interval times, restenosis rates, and postoperative complications between the two groups. Factors affecting AVF patency were analyzed by Cox regression analysis and Kaplan-Meier curves. Subgroup analysis was used to evaluate the variations in the relationships between relevant variables and patency under different access route baselines. Results: Compared with venous access, arterial access PTA demonstrated superior primary patency, with 6-month rates of 76.6% vs. 46.0% ( Conclusion: Compared with venous access, arterial access PTA offered superior primary patency and lower restenosis for juxta-anastomotic AVF lesions. Diabetes, elevated FDP, and D-Dimer predicted patency loss, with the prognostic impact varying according to the vascular access route.