PURPOSE To determine the efficacy of a percutaneous sharp needle recanalization technique for the treatment of peripheral hemodialysis arteriovenous fistula (AVF) occlusion. MATERIALS AND METHODS This study included 13 patients (14 procedures) between May 2010 and February 2020 with non-thrombotic AVF occlusion wherein guidewire passage through the occluded segment had failed. We successfully passed the guidewire through the occluded segment using a sharp needle recanalization technique with Chiba or Colapinto needles, under ultrasound or fluoroscopic guidance. The type of AVF, site and length of occlusion, technical success, complications, and long-term patency were analyzed. RESULTS Technical success was achieved in 12 (85.7%) out of 14 procedures. The procedure failed in two patients due to the poor angle of approach in the axillary area and diffuse severe stenosis in the draining cephalic vein. In eight procedures, sharp needle recanalization was performed under ultrasound guidance, while the other six procedures were performed under fluoroscopic guidance. Chiba and Colapinto needles were used in five and nine procedures, respectively. The mean length of occlusion was 2.7 cm (range 1.8-4.2 cm). There was one case of mild complication, that is, mild contrast extravasation, which was treated by stent deployment. The post-intervention primary patency rates at 6 months, 1 year, and 2 years were 81.8%, 36.4%, and 18.2%, respectively. CONCLUSION The results of this limited series suggest that the sharp needle recanalization technique is a simple and effective method for the treatment of peripheral non-thrombotic AVF occlusion.

中文翻译：

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外周血液透析动静脉瘘闭塞的尖针再通技术。

目的 确定经皮尖针再通技术治疗外周血液透析动静脉瘘 (AVF) 闭塞的疗效。材料和方法 本研究纳入了 2010 年 5 月至 2020 年 2 月期间的 13 名患者（14 次手术），他们患有非血栓性 AVF 闭塞，其中导丝通过闭塞节段失败。在超声或透视引导下，我们使用 Chiba 针或 Colapinto 针使用尖锐的针再通技术成功地将导丝穿过闭塞段。分析了 AVF 的类型、闭塞部位和长度、技术成功率、并发症和长期通畅性。结果 14 次手术中有 12 次（85.7%）取得了技术上的成功。由于腋窝区域的入路角度差和引流头静脉严重狭窄，两名患者的手术失败了。在 8 个手术中，在超声引导下进行锐针再通，而其他 6 个手术在透视引导下进行。Chiba 和 Colapinto 针分别用于五个和九个程序。闭塞的平均长度为 2.7 厘米（范围 1.8-4.2 厘米）。有一例轻度并发症，即轻度对比剂外渗，通过支架置入治疗。干预后 6 个月、1 年和 2 年的主要通畅率分别为 81.8%、36.4% 和 18.2%。