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Abstract
Objective: In ESRD (End-stage renal disease (ESRD) and superficial veins > 3.0 mm, autogenous arteriovenous fistulas (AVF) have greater patency rates than prosthetic grafts and central lines (1). . This study aimed to assess whether suboptimal veins (less than 2.0 mm) after Venoplasty with Fogarty catheter can yield similar results when used for dialysis access creation.
Methods: This Quasi-experimental study was conducted at the Department of Vascular Surgery, Holy Family Hospital, Rawalpindi, from June to December 2025.
All candidates with good-sized veins (> 3 mm) were included in group A (control group). All candidates with suboptimal veins (3 mm to 1.5 mm) were included in group B (interventional group). An end-to-side fistula using Prolene 6/0 was created between the cephalic veins of the arm or forearm and the arteries (radial/brachial). In group B, a 3 Fr Fogarty embolectomy catheter was used for venoplasty of at least a 15 cm venous segment for 10 s. Continuous variables were compared using the t-test, and categorical variables were compared using the chi-square test. A P-value of < 0.05 was considered significant.
Results: At six weeks, the average vein diameter across all instances was 4.79 ±1.14 mm. It was 4.84 ±1.16 mm in the Fogarty group, while it was 4.73 ±1.15 mm in the control group. The difference was insignificant (p = 0.76). The flow at 6 weeks was higher in the Fogarty group (57.1%) than in the control group (28.6%); however, this was insignificant (p = 0.061).
Conclusion: Fogarty catheter-assisted venoplasty appears to be feasible and safe for selected patients with suboptimal cephalic veins undergoing arteriovenous fistula creation. Although the early six-week flow showed a favourable trend in the Fogarty group, the difference was not statistically significant. Larger studies with longer follow-up periods are required to determine the effect of this technique on fistula maturation and long-term patency.
Keywords: Arteriovenous Fistula, Renal Dialysis, Kidney Failure, Chronic, Angioplasty, Balloon, Embolectomy, Balloon, Vascular Patency, Vascular Access Devices, Veins, Treatment Outcome
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