Angioplasty, also called balloon angioplasty or percutaneous transluminal angioplasty (PTA), is a minimally invasive interventional procedure in which an inflatable balloon-tipped catheter is introduced through the skin into the vascular lumen to open a stenotic segment of the vessel. Angioplasty may be performed with or without stenting as indicated 1.
Common indications of angioplasty include atherosclerosis, coronary artery stenosis, renal artery stenosis, and fibromuscular dysplasia. Angioplasty is used to treat venous stenosis affecting the haemodialysis vascular access 2.
Venous angioplasty
Chronic shear stress and fibromuscular hyperplasia in the peripheral venous outflow tract cause fibrosis in arteriovenous fistulas and grafts, leading to stenosis, high pressure in the fistula/graft, and thrombosis. Usually, 4 to 10 mm diameter balloons are used. Occasionally, balloon pressures of 20 to 24 atm may be used to dilate the stenotic site. Peripheral cutting balloons are used when high-pressure balloons do not dilate the stenotic site 3.
Venography of the entire outflow tract until the superior vena cava is performed to rule out central vein stenosis. Treatment of the incidental finding of central vein stenosis is controversial. Angioplasty of asymptomatic central vein stenosis may lead to rapid stenosis compared to watchful waiting, Balloon catheter up to 14 mm in diameter is used to treat central vein stenosis 3.
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