动静脉内瘘(arteriovenous fistula,AVF)作为血液透析的首选血管通路，失功是限制其使用的主要原因。尽管围手术期管理的改善和手术技术的优化以及其他预防原发性AVF失功方面取得了一定进展，但这些措施在降低失功率上仍存在不足。静脉新内膜增生(neointimal hyperplasia,NIH)是导致AVF失功的主要因素，通常是炎症、缺氧和血流动力学的协同作用导致的结果。局部治疗方法通过为瘘管提供结构和功能支持，以及局部高剂量药物的直接输送，旨在提高AVF的成熟率，并减少全身性药物治疗可能带来的副作用。本文综述了多种局部血管治疗方法，以期为预防AVF失功的局部治疗提供新的思路。

Arteriovenous fistula (AVF) is the preferable modality of blood access for hemodialysis. However, AVF dysfunction is the main cause that limits its clinical use, in spite of the fact that perioperative management, surgical technology and prevention of primary AVF dysfunction have been greatly improved. The culprit of AVF dysfunction is neointimal hyperplasia, which is resulted from the comprehensive effects of inflammation, hypoxia and hemodynamic changes. Local treatment to provide structural and functional support for AVF and to deliver high dose of drugs directly to AVF site can be used to promote AVF maturation and to reduce the potential side effects from systemic drug therapies. This article reviews a series of local vascular treatment methods, offering new perspectives of therapies targeting AVF dysfunction.