الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
Hemodialysis, which is the main primary modality of renal replacement therapy (RRT), depends on the ability to maintain a good vascular access capable of sustaining high blood flow rates. The native arterio-venous fistula (AVF) is recommended as the first choice due to its superior patency and lower complication rates over grafts and catheters (Aktas et al., 2015).
Although arterio-venous fistula is the best available form of hemodialysis access, yet a significant number of fistulas never mature to support dialysis (early failure) or fail after successful use (late failure). Therefore, access surveillance is recommended to detect early failing access and to determine when intervention might lead to access salvage (Jeon et al. 2016).
Failing access is defined as AVF with a greater than 50% reduction in the caliber of normal vessel, associated with hemodynamic, functional, or clinical abnormality. Vascular access dysfunction is a major cause of morbidity and hospitalization in hemodialysis population (Abdelsalam, 2016).
Compared to surgery, PTA has several advantages, including the fact that it is relatively simple, less invasive, a shorter procedure, causes less stress to the patient, and enables immediate
dialysis without the need for central venous catheter (Hu et al., 2016).
Our study included 20 ESRD patients already on regular hemodialysis and presenting with failing AVF. All patients were submitted to percutaneous trans-luminal angioplasty to salvage their failing AVFs. The salvage rate reached 80% in which the fistulas regained their usability for hemodialysis. The primary patency rates at one year after angioplasty were 60%.