Indications for percutaneous transluminal angioplasty in functional disorders of hemodialysis shunts

: With adequate indication, PTA is an effective technique for eliminating functional restrictions of hemodialysis shunts. PTA is indicated both in stenoses which occur above all at the venous shunt arm near to fistula and in occlusions over short distances. In thrombotic occlusions over long distances, PTA is indicated when prior thrombectomy did not produce any improvement of shunt function and dilatation should eliminate a causal stenosis. Stenoses of the arterial side of the shunt can also be successfully dilated: the dilation catheter should be introduced via the venous arm of the shunt in order to avoid damage to the proximal brachial artery. PTA is not indicated in all primarily insufficient shunts.