A comparative study of percutaneous transluminal angioplasty and open surgery in relieving stenosis of type Ⅰ internal fistula stenosis

Objective To compare the short-term efficacy of open operation and percutaneous transluminal angioplasty(PTA)in relieving type I internal fistula stenosis in maintenance hemodialysis(MHD)patients. Methods A total of 29 MHD patients with type I internal fistula stenosis of vascular access by standard autogenous vascular fistula were randomly divided into two groups. Group A(15 patients)underwent PTA to remove internal fistula stenosis, and group B(14 patients)underwent open surgery to remove internal fistula stenosis. The diameter and blood flow of stenosis fistula were measured before and after operation, creatinine and urea nitrogen levels were recorded before and after dialysis, and urea clearance rate(URR)and urea clearance index(Kt/V)were calculated. Results There were statistically significant intra-group differences in preoperative and postoperative anastomotic diameter, fistula blood flow, URR and Kt/V values(P<0.05 or P<0.01), and no significant between-group differences in the above postoperative indicators were found(P>0.05). The restenosis rate of group A was higher than that of group B, and there was significant difference(P<0.05). Conclusion PTA has similar efficacy but higher postoperative recurrence rate in relieving type I internal fistula stenosis compared with open surgery, and saves vascular resources.