A comparison of efficacy of endovascular versus surgical repair for the treatment of arteriovenous fistula stenosis in Taiwan

Szu Shan Fan, Chien Wen Chen, Kuo Cheng Lu, Hung Chung Mao, Miao Pei Chen, Chu Lin Chou

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Percutaneous transluminal angioplasty (PTA) and fistula reconstruction surgery are therapeutic options for vascular access occlusion in hemodialysis patients. However, owing to its convenience, PTA has gradually become the preferred therapeutic option for fistula stenosis or occlusion. This study investigated the effects of the two therapeutic methods on the vascular access maintenance duration (number of days) and maintenance costs of fistula in dialysis patients from different dialysis units. Methodology: In this study, 544 hemodialysis patients from 2 dialysis units in a teaching hospital in the southern area of Taiwan were included in the analysis of the frequency of PTA or revascularization surgery and the use of related medical resources by conducting a retrospective chart review. Results: The frequency of PTA in the patients undergoing long-term hemodialysis was not significantly associated with their demographic characteristics. The efficacy of PTA has declined with shorter maintenance duration with increasing PTA frequency. The cost profile of PTA was more expensive than that of fistula revascularization surgery. Conclusions: In this study, PTA was found to be just a temporary solution for fistula thrombosis, whereas fistula reconstruction surgery is inexpensive and improves survival time. Therefore, dialysis units should establish an appropriate standard of care to avoid over-reliance on PTA in order to reduce the fistula failure rate, improve the dialysis efficacy, and reduce the psychological stress in patients, as well as to reduce the maintenance costs and rationalize the medical expenses.

Original languageEnglish
Pages (from-to)200-206
Number of pages7
JournalJournal of Vascular Access
Volume18
Issue number3
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Fingerprint

Arteriovenous Fistula
Taiwan
Angioplasty
Pathologic Constriction
Fistula
Dialysis
Maintenance
Renal Dialysis
Therapeutics
Costs and Cost Analysis
Blood Vessels
Therapeutic Uses
Standard of Care
Psychological Stress
Teaching Hospitals
Thrombosis
Demography
Survival

Keywords

  • Hemodialysis
  • Percutaneous transluminal angioplasty
  • Revascularization surgery
  • Vascular access

ASJC Scopus subject areas

  • Surgery
  • Nephrology

Cite this

A comparison of efficacy of endovascular versus surgical repair for the treatment of arteriovenous fistula stenosis in Taiwan. / Fan, Szu Shan; Chen, Chien Wen; Lu, Kuo Cheng; Mao, Hung Chung; Chen, Miao Pei; Chou, Chu Lin.

In: Journal of Vascular Access, Vol. 18, No. 3, 01.01.2017, p. 200-206.

Research output: Contribution to journalArticle

Fan, Szu Shan ; Chen, Chien Wen ; Lu, Kuo Cheng ; Mao, Hung Chung ; Chen, Miao Pei ; Chou, Chu Lin. / A comparison of efficacy of endovascular versus surgical repair for the treatment of arteriovenous fistula stenosis in Taiwan. In: Journal of Vascular Access. 2017 ; Vol. 18, No. 3. pp. 200-206.
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