One-year outcomes of interwoven nitinol stents for juxta-anastomotic stenosis in forearm AV fistulas: Experience in a Southeast Asian cohort

Arteriovenous fistula (AVF) dysfunction due to recurrent stenosis can compromise effective renal replacement therapy in patients with end-stage kidney disease Timely salvage of failing AVFs is therefore essential. This retrospective study evaluated the 1-year outcomes of interwoven nitinol stent placement for the treatment of dysfunctional forearm AVFs due to juxta-anastomotic stenosis in patients with end-stage kidney disease. Indications for intervention included failure to mature (n = 8), recurrent stenosis following more than two angioplasties within 6 months (n = 10), and angiographically confirmed recoil stenosis >50% (n = 11). Primary outcome measures included technical success, primary patency, assisted-primary patency, and secondary patency rates over 12 months. Technical success was achieved in all cases (100%) with no procedural complications. Mean brachial artery flow improved from 356 mL/min preintervention to 765 mL/min postintervention. Primary patency rates declined from 3 to 9 months (89.7%-50.0%), with a rate of 44.4% at 12 months. Both assisted primary patency and secondary patency rates were maintained at 90.0% and 97.0%, respectively at 12 months. No stent-related complication was observed. Interwoven nitinol stenting coupled with structured duplex surveillance and pre-emptive reintervention represents a safe and effective treatment for juxta-anastomotic stenosis in dysfunctional forearm AVFs.