Figure 57

Arteriovenous fistula anastomotic stenosis. Arteriovenous fistulas exhibit better long-term patency compared with polytetrafluoroeth-ylene (PTFE) grafts. A, This arteriogram, performed by injecting the brachial artery, demonstrates an end-to-side arteriovenous fistula involving the brachial artery and the cephalic vein. The arrow indicates an area of narrowing adjacent to the anastomosis, the most common site for a stenotic lesion in native vein fistulas. B, Angioplasty successfully eliminated the anastomotic stenosis. Limitations on balloon size are often encountered when treating lesions in arteriovenous fistulas because a portion of the balloon must often extend into the donor artery, which typically is of smaller diameter than the outflow vein.

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