Background: For an accurate assessment of structural changes in arteriovenous fistulae (AVF) a microscopic analysis is mandatory. Methods: 25 insufficient AVF were analyzed with the light microscope using standard histological and immunohistochemical techniques. Results: In 7 patients (28%) atherosclerotic lesions as causes of AVF insufficiency were found. The other 18 patients (72%) had an inhomogeneous spectrum of nonatherosclerotic lesions, for instance intimal hyperplasia. Conclusions: Histopathologic analysis of insufficient AVF helps clarify the underlying changes in the structure of the vessel wall.

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