Although radial artery rupture during percutaneous transluminal angioplasty for radiocephalic arteriovenous fistula dysfunction was relatively common (17.86%), it could be safely managed with prolonged low-pressure balloon inflation and localized compression, and did not appear to compromise long-term access-circuit patency.
Technical success was achieved in all 56 patients undergoing percutaneous transluminal angioplasty (PTA) for radial artery stenosis causing arteriovenous fistula dysfunction.
Radial artery rupture occurred in 10 of 56 patients (17.86%) during percutaneous transluminal angioplasty.
At 1 year, primary patency rates were not significantly different between the rupture group and the normal group.
At 1 year, secondary patency rates were not significantly different between the rupture group and the normal group.
Radial artery rupture during PTA did not appear to compromise long-term access-circuit patency in this cohort.
This research examined what happens when the radial artery (the artery in the forearm) tears or ruptures during a balloon-based procedure used to open up narrowed blood vessels in patients who rely on a type of dialysis access called a radiocephalic arteriovenous fistula. These fistulas connect an artery and vein to allow for hemodialysis, and they frequently develop narrowings that need to be treated. The study followed 56 patients treated at a single center over about four years. It found that artery rupture happened in nearly 1 in 5 patients (about 18%) during the balloon procedure, which is a notable occurrence. Importantly, all ruptures were successfully treated by simply keeping the balloon inflated at low pressure for a longer period and applying gentle pressure from outside the skin — no surgical repair or metal stents were needed. The key practical finding is that patients whose arteries ruptured during the procedure did not have worse long-term outcomes compared to those whose arteries did not rupture. One year after treatment, about 40% of patients in both groups still had a functioning fistula without needing any additional procedures (primary patency), and about 87–90% still had a functioning fistula even after accounting for any additional interventions needed to keep it working (secondary patency). These differences were not statistically meaningful. This research suggests that artery rupture during balloon dilation for dialysis access problems, while alarming-sounding, can often be managed safely without escalating to more invasive treatments, and does not appear to harm the long-term function of the dialysis access. This has potential implications for how interventionists approach and counsel patients about this complication, though the study's single-center, retrospective design and relatively small sample size mean that larger, multi-center studies would be needed to confirm these findings.
Yin J, Wei J, Fu L, Wang W, Wang F. (2026). Clinical impact of radial artery rupture during percutaneous transluminal angioplasty for radiocephalic arteriovenous fistula dysfunction: A single-center retrospective study.. The Journal of international medical research. https://doi.org/10.1177/03000605261480900