Balloon Angioplasty to Facilitate Autogenous Arteriovenous Access Maturation: A New Paradigm for Upgrading Small-Caliber Veins, Improved Function, and Surveillance

Balloon angioplasty maturation is emerging as an important method to increase utilization and improve function of autogenous arteriovenous hemodialysis accesses (AVFs). Through the sequential dilation of small veins, large-diameter AVFs can be created with the inherent benefits of easier cannulation, greater overall surface area, improved patency, and fewer complications. A usable AVF can be created in a shorter amount of time, decreasing the need for dialysis catheters. In addition, selective angioplasty of the AVF inflow and outflow can facilitate improved flow rates and increase access longevity. Our approach, including primary balloon angioplasty during AVF creation, sequential balloon angioplasty maturation, and surveillance fistulagrams will be presented.