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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The maturation rate for arteriovenous fistulas (AVFs) used in haemodialysis varies from 30% to 76% for unassisted maturation. Notably, up to 70% of AVFs may require interventions to achieve successful maturation. AVFs that do not mature are typically addressed by creating a new AVF at a different site or by placing a tunnelled central venous catheter in our region. This study aims to evaluate the outcomes of assisted maturation in our population, providing valuable insights for the improved management of immature AVFs.
This prospective observational study involved 18 patients who underwent percutaneous transluminal angioplasty (PTA) for immature arteriovenous fistulas (AVFs). The study was conducted from January 2023 to December 2024 at a single centre in Northeast India. PTA was performed by a trained interventional nephrologist in the catheterization lab of a tertiary care hospital.
Patients with immature arteriovenous fistulas (AVFs), as well as those with inflow or outflow lesions identified during clinical examination, difficult or impossible cannulation, or an insufficient blood flow rate of less than 200 ml/min between 1.5 to 4 months after AVF creation, were included in the study.
Written consent was obtained from all patients, during which the benefits, risks, and alternative options were thoroughly explained. Case selection was conducted randomly. Patients were excluded from the study if they had extensive clotting, large or multiple aneurysms, or a non-functional (dead) AVF.
The procedure was conducted in the catheterization lab using fluoroscopy and contrast media under local anaesthesia while maintaining sterile conditions. The equipment used for the procedure included access needles (Jelco) and vascular sheaths (6-8 Fr), catheters (multipurpose and support), guidewires (ranging from 0.035’’ to 0.014’’ with regular, stiff-tip, and straight designs), and angioplasty balloons (5-8 mm, normal and high pressure). AVFs were accessed by cannulating the radial artery and fistula vein. A standard PTA protocol was followed, utilizing both low-pressure balloons (Mustang, Chameleon by Medtronic) and high-pressure balloons (Conquest). Cutting balloons and drug-eluting balloons were not employed due to their high costs. Heparin was administered routinely. Balloon inflation times varied from 30 seconds to 2 minutes. Pain relief was achieved through a combination of fentanyl and midazolam.
Outcome parameters included fistula patency, defined as the time from intervention to the first occurrence of failure (including thrombosis, restenosis, or abandonment or death), as well as median time to failure and primary failure rates. Patients were followed up on an outpatient basis, with monthly visits to the respective dialysis unit. Data analysis was performed using Microsoft Excel.
A total of 18 patients were enrolled in the study from January 2023 to December 2024. The mean age of the participants was 61.16 years, with a standard deviation of 15.13 years (age range: 17 to 82 years). The male-to-female ratio was 11:7. The underlying kidney diseases among the patients were as follows: Diabetes in 10 patients (55.5%), Systemic Lupus Erythematosus (SLE) in 1patients (5.5%), Hypertension in 4 patients 22.2%), and Chronic Kidney Disease (CKD) of unknown aetiology in 3 patients (16.6%).
The distribution of arteriovenous fistulas (AVFs) was as follows:
- Brachio-basilic: 1 (5.5%)
- Radio-cephalic: 15 (83.3%)
- Brachio-cephalic: 2 (11.1%)
The distribution of access sites used was:
- Radial artery: 11 (61%)
- Fistula vein: 7 (39%)
Distribution of lesions: A single lesion was observed in 7 patients (38.8%), while multiple lesions were found in 9 patients (50%), diffuse lesion in 2 patients(11.2%).
OUTCOME:
Out of 18 immature AVFs, immediate success was obtained in 12(67%) patients. In 6(33%) patients, it was unsuccessful. Three of these patients experienced rupture vein and subsequent infection which was manged conservatively. One patient had multiple arterial lesions and two patients developed thrombosis.
The average patency time after PTA was 8.14 months, and the patency rates after PTA at 3 months (n=12) and 6 months (n=10) were , 75% and 60%, respectively. The median time of recurrence was 7.5 month, range was 3 to 18.5 months.
Drawbacks of the study: Sample size is low. Delofting was not performed. Procedure performed by single nephrologist who is in early phase of experience.
Percutaneous transluminal angioplasty for immature arteriovenous fistulas (AVFs) has a high success rate, with a median time until lesion recurrence of 7.5 months. The patency rate following PTA is satisfactory, with rates of 75% at 3 months and 60% at 6 months. However, there is an increased risk of rupture and infection. Additionally, multiple lesions are common in our region.
