Objective:To investigate the influence factors of failure to open thrombotic occlusion of internal fistula in ultrasound-guided percutaneous transluminal angioplasty(PTA).Methods:A total of 173 patients with arteriovenous fistula thrombotic occlusion who were treated in Yichang Central People's Hospital from January 2020 to October 2023 were retrospectively selected.All patients received ultrasound-guided PTA treatment,and were divided into the successful group and the failed group according to whether the internal fistula thrombotic occlusion was successfully opened.The general data of the two groups were compared.The influence factors leading to the failure of opening thrombus occlusion of internal fistula were analyzed by multivariate Logistic regression.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of each factor.Results:Among the 173 patients enrolled,the success rate of opening fistula thrombotic occlusion after ultrasound-guided PTA was 77.46％(134/173).There were significant differences in age,diabetes mellitus,occlusion location,occlusion length,length of internal fistula use,calcification at occlusion location and hemoglobin level between the successful group and the failed group(all P＜0.05).Multivariate Logistic regression analysis showed that the occlusion at the anastomotic segment(OR=6.322,95％CI:1.689,23.162),occlusion length ≥3 cm(OR=3.087,95％CI:1.403,6.786)and the occlusion location calcification(OR=6.605,95％CI:1.159,38.304)were the influential factors of the failure to open fistula thrombotic occlusion in ultrasound-guided PTA(all P＜0.05).ROC curve showed that occlusion at the anastomotic segment(AUC=0.889),occlusion length≥3 cm(AUC=0.861)and occlusion location calcification(AUC=0.738)had significant predictive value for the failure of opening intra-fistula thrombotic occlusion in ultrasound-guided PTA.Conclusion:The occlusion at the anastomotic segment,the occlusion length ≥3 cm and the occlusion location calcification are independent influencing factors for the failure of opening internal fistula in ultrasound-guided PTA.
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