Recently, the dialysis access team of Department of Nephrology of the First Affiliated Hospital of Xi 'an Jiaotong University (XJTU) successfully performed ultrasound-guided covered-stent implantation for one patient with artificial vascular fistulastenosis. It is the first case of ultrasound-guided covered-stent implantation via dialysis access in Shaanxi province, signifying the significant improvement in the interventional treatment technology via dialysis access of our hospital.

A 55-year-old male patient was diagnosed with chronic nephritis and chronic renal failure. He received artificial vascular fistula dialysis in the left forearm for 1 year on a regular basis. He had received two percutaneous transluminal balloon angioplasty (PTA) because of the artificial vascular fistula stenosis, which recurred rapidly after PTA. For patients with high-risk stenosis recurrence and low efficacy after PTA alone, covered-stent implantation serves as a better solution.Yang Shifeng, Deputy Chief Physician from Department of Nephrology, and his team successfully performed ultrasound-guided covered-stent implantation for the patient. Postoperatively, the blood flow of the artificial vascular fistula was recovered smoothly, and the blood flow was sufficient and the venous pressure was normal during dialysis. High surgical efficacy was achieved.

Interventional therapy is the most efficacious treatment of arteriovenous fistula stenosis in uremic patients. Conventional stent implantation is performed under DSA, whereas ultrasound-guided stent implantation has multiple advantages of convenience, no radiation-induced injury, no contrast-induced damage and displaying occlusive lesions, which is especially recommended for interventional therapy via dialysis access.

To meet the requirements of clinical diagnosis and treatment, Department of Nephrology of our hospital has established a dialysis access group to continually explore novel medical technologies. In 2016, our hospital became the first to perform different ultrasound-guided interventional therapies via dialysis access in Shaanxi province, including PTA, arteriovenous fistula thrombectomy, arteriovenous fistulaballoon dilatation and maturation, and closure and repair of pseudoaneurysm of arteriovenous fistula,etc. The implementation of ultrasound-guided covered-stent implantation further improves the interventional treatment technology via the dialysis access, better maintain the dialysis access and safeguard the lives of patients undergoing dialysis.