Journal of Vascular Access最新文献

{"title":"A new technique for treating seroma following arteriovenous graft surgery.","authors":"Jingyi Lin, Jie Huang, Huanghuan Liu, Zongchao Yu, Bo Hu, Shuang Cui","doi":"10.1177/11297298251366731","DOIUrl":"https://doi.org/10.1177/11297298251366731","url":null,"abstract":"<p><p>Seroma is a relatively uncommon complication following arteriovenous graft (AVG) procedures, and it is typically managed through conventional methods such as limb elevation, far-infrared irradiation, and ultrasound-guided puncture drainage. We report the case of a 51-year-old hemodialysis patient who was admitted due to persistent swelling at the anastomosis site of a left upper limb AVG for 3 months. Upon evaluation, the patient was diagnosed with a left AVG arterial end seroma. In response to this clinical problem, we propose an innovative treatment strategy. Initially, compression was applied to the AVG to reduce swelling. Subsequently, temporary dialysis access was established to meet the patient's ongoing dialysis needs, while the timing of percutaneous transluminal angioplasty (PTA) intervention was carefully considered. Following the implementation of this novel approach, the patient exhibited significant recovery in AVG function, with no recurrence of seroma swelling noted to date. This case highlights the potential for alternative therapeutic strategies in managing seromas associated with AVG, suggesting a shift toward more individualized treatment protocols.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251366731"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous anchored securement of centrally inserted central catheter in intensive care unit: A pilot study.","authors":"Francesco Tomeo, Italo Calamai, Marco Luchini, Irene Mori, Andrea Giannini, Rosario Spina","doi":"10.1177/11297298251369060","DOIUrl":"https://doi.org/10.1177/11297298251369060","url":null,"abstract":"<p><strong>Background: </strong>Centrally inserted central catheters (CICCs) are critical devices in intensive care settings, where patients often require life-saving therapies. However, the stability of these devices is essential to avoid dislodgement, migration, and therapy interruptions. Adhesive sutureless securements devices are challenging in terms of dislodgment rates, while sutures must be avoided. SAS (Subcutaneous anchored Securement Device) is widely used in Peripherally inserted central catheters (PICC) to reduce dislodgement rate and improve cost effectiveness, but its use in ICU is still limited.</p><p><strong>Objective: </strong>To evaluate the incidence of CICC dislodgement using SAS in a second-level hospital ICU and assess whether its use increases catheter dwell time.</p><p><strong>Methods: </strong>A prospective, observational, single-center study involving 100 ICU patients at high risk of CICC dislodgement was conducted. A total of 126 CICCs were placed and secured with SAS (SecurAcath), and outcomes were monitored.</p><p><strong>Results: </strong>The dislodgement rate for SAS-CICCs was 4% (1.93 dislodgements per 1000 catheter days). The average catheter dwell time was 17.25 days, longer than adhesive securement devices (12.3 days). No device failures, local infections, or exit-site complications were reported.</p><p><strong>Conclusion: </strong>SAS effectively stabilizes CICCs, reduces dislodgement rates, and extends catheter dwell time in high-risk ICU patients, aligning with 2024 GAVeCeLT guidelines.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251369060"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of local warming in facilitating peripheral intravenous cannulation: A systematic review and meta-analysis.","authors":"Gautham Patel, Shubhkarman Kahlon","doi":"10.1177/11297298251371757","DOIUrl":"https://doi.org/10.1177/11297298251371757","url":null,"abstract":"<p><strong>Background: </strong>Peripheral venous cannulation is a critical yet sometimes difficult procedure, especially in pediatric or vasoconstricted patients. Local warming has been proposed to enhance venous dilation and improve cannulation success.</p><p><strong>Objective: </strong>To evaluate the effect of local warming on peripheral venous cannulation success rates and vascular cross-sectional area (CSA).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Databases searched included PubMed, Scopus, Embase, and Cochrane Library up to June 2025. Randomized controlled trials (RCTs) assessing the impact of local warming versus control on venous cannulation outcomes were included. Risk ratios (RRs) and standardized mean differences (SMDs) with 95% confidence intervals (CI) were pooled using a random-effects model. Risk of bias and GRADE certainty were assessed.PROSPERO registration:CRD420251067877.</p><p><strong>Results: </strong>Five RCTs involving both pediatric and adult populations were included. Local warming significantly improved cannulation success (RR: 1.30, 95% CI: 1.17-1.45; <i>I</i>² = 0%). It also increased vascular CSA (SMD: 0.91, 95% CI: 0.65-1.17; <i>I</i>² = 0%). Subgroup analysis revealed consistent benefits in pediatric patients. Sensitivity analyses confirmed robustness of findings. Funnel plot showed no major publication bias.</p><p><strong>Conclusions: </strong>Local warming is an effective, non-invasive intervention to improve peripheral venous access, particularly in pediatric patients. It significantly enhances both cannulation success and vascular CSA with high consistency across studies.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251371757"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Nrf2-Keap1-ARE signaling pathway-related proteins on arteriovenous fistula thrombosis.","authors":"Qin Zou, Qiong Wu, Zhichao Liu, Xiangping Liao, Xiaowen Fan","doi":"10.1177/11297298251375520","DOIUrl":"https://doi.org/10.1177/11297298251375520","url":null,"abstract":"<p><strong>Background: </strong>To analyze the effect of the expression of proteins related to the nuclear factor E2-related factor 2 (Nrf2)-Kelch-like epichlorohydrin-associated protein 1 (Keap1)-antioxidant response element (ARE) signaling pathway on arteriovenous fistula (AVF) thrombosis.</p><p><strong>Methods: </strong>One hundred and twenty-two patients with chronic renal failure who underwent maintenance hemodialysis (MHD) at our hospital from October 2019 to March 2023 were selected. Serum Nrf2, Keap1, and ARE expression levels were measured using real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and serum oxidative stress markers were determined using chemical colorimetry. Patients were classified into an AVF thrombus group (<i>n</i> = 42) and an AVF patency group (<i>n</i> = 80) based on the presence of AVF thrombosis.</p><p><strong>Results: </strong>The relative expression levels of Nrf2, Keap1, and ARE in the AVF thrombus group were significantly lower than those in the AVF patency group (<i>p</i> < 0.05). The levels of SOD and GSH-Px in the AVF thrombus group were lower, while the level of MDA was higher compared to the AVF patency group (<i>p</i> < 0.05). Multivariate Logistic regression analysis identified diabetes mellitus, hypotension, elevated levels of MDA, Hb, and CRP as risk factors for AVF thrombosis (OR > 1, <i>p</i> < 0.05), while elevated levels of Nrf2, Keap1, ARE, SOD, and GSH-Px were protective factors (OR < 1, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Patients with AVF thrombosis exhibit low serum Nrf2, Keap1, and ARE expression levels, which is closely associated with oxidative stress. Activating the Nrf2-Keap1-ARE signaling pathway holds promise as a target for the prevention and treatment of AVF thrombosis.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251375520"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetrasodium EDTA central venous catheter lock solution in home parenteral nutrition patients: Ease of use and patient satisfaction, a prospective study.","authors":"Lina Saucedo, Yasaman Ghorbani, Maria Heusser, Giulia Chagas, Celeste Arca, Katherine J P Schwenger, Johane P Allard","doi":"10.1177/11297298251376970","DOIUrl":"https://doi.org/10.1177/11297298251376970","url":null,"abstract":"<p><strong>Objective: </strong>Chronic intestinal failure is a devastating chronic medical condition, which requires central venous access for parenteral nutrition infusion. The presence of a central venous line is associated with an increased risk of bloodstream infection and thrombosis. Currently, the heparin lock is the most used catheter lock, but still has risks for line infection. The 4% tetrasodium EDTA catheter lock (KiteLock™) solution, has demonstrated a decrease in infection and thrombosis risk, but requires extra steps for the preparation and infusion. The objective of this study was to evaluate the patients ease-of-use and acceptability of the new KiteLock solution in the home parenteral nutrition (HPN) patients.</p><p><strong>Methods: </strong>This prospective, open-label, single-center study evaluated patient acceptability of tetrasodium EDTA (KiteLock) in HPN. Patients were contacted four times, beginning with an instructional visit by the HPN nurse. They then completed three 30-day phases: standard heparin/saline flush, tetrasodium with withdrawal (when feasible), and tetrasodium EDTA. During the final week of each phase, patients completed a phone survey and questionnaire with the HPN nurse.</p><p><strong>Results: </strong>Of the 21 patients enrolled, 14 completed the study. Seven did not: two withdrew due to time constraints, two found KiteLock difficult to infuse, and three had incomplete data. Among those who competed the study, some reported reduced ease-of-use with KiteLock (1 hard to open, 5 difficulties withdrawing, 1 overall difficulty), though most still rated it easy or very easy. Three patients continued to find it more difficult by study end. No adverse effects were reported. Preparation time decreased over time as patients adapted. Initial satisfaction with KiteLock was lower (50% find it neutral), but improved with familiarity, becoming comparable to heparin with 12 patients satisfied (<i>N</i> = 14).</p><p><strong>Conclusions: </strong>KiteLock solution is well accepted by the patient or caregiver, despite involving more steps to use it.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251376970"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of minimally invasive dialysis access.","authors":"Ngoh C Liew, Sarah Chew, Pei Ho, John Swinnen, Robert Shahverdyan, Shannon D Thomas","doi":"10.1177/11297298251371764","DOIUrl":"https://doi.org/10.1177/11297298251371764","url":null,"abstract":"<p><strong>Objective: </strong>Minimal Invasive Dialysis Access (MIDA) for renal dialysis encompasses percutaneous arteriovenous fistula (pAVF) creation and the modified percutaneous Seldinger peritoneal dialysis catheter insertions (pPD). This review examines the impact of MIDA on technical success, maturation rates, patency, clinical benefits, complications, and cost.</p><p><strong>Methods: </strong>A review was made of the literature on MIDA including pAVF creation and pPD insertion regarding technical success rates, maturation rates, patency, clinical benefits, complications, and cost. Additional benefits of pAVF such as expansion of cannulation area and reduction of steal syndrome, and associated administrative challenges was assessed.</p><p><strong>Results: </strong>Percutaneous AVF can be performed outside the operating room by interventionalists and physicians of several specialties. Initial reports claim safe and efficacious use and equivalent patency to open surgery (sAVF). Percutaneous AVF with multiple venous outflows has the benefit of expanding the area for cannulation. The incidence of wound infection and steal syndrome is reduced. Most studies have been retrospective and there are no prospective randomized controlled trials. The cost-effectiveness of pAVF versus sAVF has been challenged. The recently modified pPD has reduced incidence of catheter misplacement with improved catheter survival. With equivalent efficacy and complication rates reported in prospective studies and without the need for surgery and general anesthesia, pPD should be cost-effective in skilled centers.</p><p><strong>Conclusions: </strong>MIDA is an innovative approach to dialysis access that offers benefits over open surgery. MIDA advantages include widened indications to the very sick patients, being performed under ultrasound and fluoroscopic guidance with local anesthesia. New devices are being developed that may meet stricter criteria with improved efficacy. The cost of device and added procedures required for maturation and patency may prevent widespread application for now. Real-world data is needed to determine long term clinical outcomes and cost-effectiveness. Additional skills training and team collaborations are likely key factors for success.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251371764"},"PeriodicalIF":1.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of lidocaine injection for the cannulation of arteriovenous fistulas in patients undergoing maintenance hemodialysis.","authors":"Baodan Liao, Xiaoqing Wang, Yinping Qin, Xiaomei Wang","doi":"10.1177/11297298251372331","DOIUrl":"https://doi.org/10.1177/11297298251372331","url":null,"abstract":"<p><strong>Background: </strong>To investigate the efficacy of lidocaine injection for the cannulation of arteriovenous fistulas in patients undergoing maintenance hemodialysis (HD).</p><p><strong>Methods: </strong>The clinical data of 91 patients who underwent arteriovenous fistula puncture and maintenance HD at our hospital from December 2023 to July 2024 were retrospectively analyzed. The patients were divided into groups based on the different pre-cannulation treatment methods. The control group (<i>n</i> = 43) underwent cannulation after routine disinfection, whereas the study group (<i>n</i> = 48) underwent cannulation following a local injection of 0.2% lidocaine.</p><p><strong>Results: </strong>The cannulation success rate was significantly higher in the study group (97.92%) than in the control group (81.40%). After cannulation, the heart rate and the systolic blood pressure in the study group were notably lower than those in the control group. After cannulation, the scores of the study group on the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and the Chinese version of the Perceived Stress Scale were markedly lower than those of the control group. Pain levels in the study group were also significantly lower than those in the control group. The General Comfort Questionnaire and total scores in the study group were also significantly lower than those in the control group. The complication rate in the intervention group (2.08%) was significantly lower than that in the control group (18.60%), and the satisfaction rate in the study group was 95.83% (46/48), which was significantly higher than that in the control group (79.07% (34/43)).</p><p><strong>Conclusions: </strong>Local injection of 0.2% lidocaine effectively alleviated pain during arteriovenous fistula cannulation, improved comfort, and reduced complications in maintenance HD patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251372331"},"PeriodicalIF":1.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-valve stent graft placement to reduce edge stenosis for recoil venous anastomotic stenosis in arteriovenous graft hemodialysis patients.","authors":"Huei-Lung Liang, Matt Chiung-Yu Chen, I-Li Su, Chia-Ling Chiang, Chien-Liang Chen","doi":"10.1177/11297298251364334","DOIUrl":"https://doi.org/10.1177/11297298251364334","url":null,"abstract":"<p><strong>Purpose: </strong>Although stent grafts have demonstrated significant benefits over bare metal stents and conventional venoplasty at maintaining patency of dialysis vascular access, they are far from perfect and are prone to edge stenosis. A new strategy of placing stent graft to reduce the possible occurrence of edge stenosis is therefore proposed in this study.</p><p><strong>Materials and methods: </strong>A retrospective review between 2015 and 2023 identified 21 arteriovenous grafts (AVG) hemodialysis patients who underwent stent graft placement with the medial stent end in an outflow venous valve. The indications for stent graft placement were either due to frequent recoil venous anastomotic stenoses recalcitrant to venoplasty or vascular ruptures after balloon dilation. Stent grafts of 6-7 mm in diameter were deployed crossing the venous anastomosis onto a venous valve. The primary stent-end patency, primary and secondary access patency were calculated with Kaplan-Meier analysis.</p><p><strong>Results: </strong>Technical success was achieved in 100% of the 21 patients. The median primary stent-end patency was 24 months with the patency rates at 12- and 24-month of 65.3% and 43.5% respectively. Six patients had in-stent stenosis and three patients had stent graft downward migration, resulting in edge stenosis. The secondary access patency rates at 1- and 2-year were 100% and 94.7%, respectively. No major complications were encountered in this study.</p><p><strong>Conclusion: </strong>Placing the stent graft end in an outflow venous valve seems to reduce occurrence of the edge stenosis, and therefore prolong the stent graft patency.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251364334"},"PeriodicalIF":1.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of ultrasonography and color-Doppler for early prediction of hemodialysis arteriovenous fistula unassisted maturation.","authors":"Shailendra K Chaudhary, Nitin Arun Dikshit, Neha Yadu, Anit Parihar, Neera Kohli, Durgesh Kumar Dwivedi","doi":"10.1177/11297298241282263","DOIUrl":"10.1177/11297298241282263","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous fistula (AVF) failure is a prevalent concern for patients with end-stage kidney disease on hemodialysis. Recognizing the efficacy of ultrasound Doppler in post-operative AVF evaluation, this study sought to discern the predictive capabilities of various ultrasonographic and color-Doppler metrics for early AVF outcomes.</p><p><strong>Methods: </strong>This single-center, prospective cohort study spanned 1 year and, post ethical clearance, included all patients who underwent native AVF creation surgery and were subsequently referred for standard post-operative ultrasound Doppler assessment. Parameters such as fistula size, cephalic vein area and diameter, and AVF flow velocity and rates were assessed on post-operative day 2, week 2, and week 6. These initial findings were juxtaposed with later outcomes to determine unassisted AVF results.</p><p><strong>Results: </strong>Of the initial cohort of 40 patients, 75% encountered AVF failure, whereas 25% realized successful unassisted AVF maturation. A notable observation was the significant variance in AVF flow rates as early as post-operative day 2. A threshold of >246 ml/min was indicative of successful unassisted AVF maturation, leading to a sensitivity of 80% and a specificity of 70%. Although the cephalic vein diameter on post-operative day 2 lacked a robust association with AVF outcomes, a cut-off of >3.4 mm, when combined with flow rate testing, augmented the cumulative sensitivity to 92%.</p><p><strong>Conclusion: </strong>Ultrasound Doppler stands out as a valuable quantitative imaging modality, adept at prognosticating AVF outcomes from as early as post-operative day 2. In particular, a flow rate exceeding 246 ml/min and a cephalic vein diameter surpassing 3.4 mm are salient indicators for the early prediction of successful AVF outcomes.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1495-1503"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Juxta-anastomotic stenosis in the forearm native arteriovenous fistula: Open surgery or angioplasty?","authors":"Sara Dominijanni, Germana Sfara, Paola Tatangelo, Roberto Cancellieri, Alessio Spinelli, Alessia Centi, Ilaria Mariani, Luigi Maria Ammirati, Giulia Marrone, Anna Mudoni, Annalisa Noce, Roberto Palumbo","doi":"10.1177/11297298241293204","DOIUrl":"10.1177/11297298241293204","url":null,"abstract":"<p><strong>Background: </strong>The juxta-anastomotic stenosis (JAS) represents the major complication of arteriovenous fistula (AVF) during the first months after the surgery and the approach to JAS can be surgical or radiological.</p><p><strong>Methods: </strong>From 01/02/2016 to 31/12/2020, a total of 976 radiocephalic fistulas have been performed. The 15.9% of AVF was malfunctioned due to JAS. A retrospective analysis was conducted on 156 patients with JAS, in order to compare the primary outcome of surgery and percutaneous angioplasty (PTA) in JAS treatment, in the lower forearm in a follow-up of 24 months.</p><p><strong>Results: </strong>Ninety patients underwent to surgery and 66 to PTA, mean age was 63.43 ± 14.54 and 65.10 ± 15.10 years, respectively. Frequencies of diabetes mellitus and arterial hypertension were similar by groups. Cardiovascular disease was present in 20% of the surgery patients and in 42.4% PTA patients (<i>p</i> = 0.04). The primary assisted patency was 84.4% and 71.1% in the surgery group at 12 and 24 months and 54.5% and 69.6% in the PTA group. The secondary patency at 24 months was 95.6% for surgery group and 96.9% for PTA group, without a statistical significance. During the study period, 10 AVFs (11.1%) showed a restenosis in the surgical group and 14 (21.2%) in the PTA group.</p><p><strong>Conclusions: </strong>This retrospective study suggests a higher restenosis rate after PTA than surgery. However, the statistical analysis shows that the failure rate of the two procedures is comparable. A dedicated multidisciplinary team could represent the goal for a good clinical practice in the treatment of JAS.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1693-1703"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}