Method to treat dialysis graft outelt stricture

Outlet stricture is the most common problem of dialysis graft. If not treated properly, it may lead to dialysis graft thrombosis. How can we deal with dialysis graft outlet stenosis?
Traditionally, surgeons can do an venous outlet revision, either by patch angioplasty or jump graft revision, to address the problem of graft outlet stricture. its a rather staightforward way to treat the lesion. However, surgical revision needs surgical exploration of the vessel and is more invasive and time consuming. (compare to recently endovascular method)
Nowadays we can treat the lesions using P.T.A.. That is to say, we may dilate the stricture using angioplasty balloon percutaneously. However, rocoil or recurrence of the stenosis may need repeated procedures.
And if the lesion is refractory to angioplasty alone or it recured early, we may put in stents to prevent the recoil of the lesion. In my experience, we should put in covered stents in stead of bare metal stents to treat the dialsis graft outelt lesions. Because it seems that the bare stents do have the problem of in-stent stenosis in short time.

The picture showes here depict a typical graft outlet lesion, which is refractory to P.T.A, successfully treated using a covered stent uneventfully(Fluency, Bard)