Exploratory Research of PCSK9 Inhibitor on Patency of aAVF After PTA With PCB

Inclusion Criteria: 1. Agree to join this study and sign an informed consent form 2. Age ≥ 18 years old and ≤ 75 years old, regardless of gender 3. Maintenance hemodialysis patients using autologous arteriovenous fistula (AVF), with a dialysis frequency of three times a week 4. AVF venous stenosis: The local stenosis rate exceeds 50% of the normal diameter of nearby blood vessels and is accompanied by at least one of the following conditions: 1. The natural blood flow of the internal fistula is less than 500ml/min or has decreased by more than 25% compared to the previous examination result 2. Unable to meet the required blood flow for dialysis prescription (blood flow\<200ml/min, and cannot be corrected after adjusting the puncture needle position) 3. Decreased arterial pressure or increased venous pressure during dialysis (monitoring arterial pressure\<-120mmHg for more than 2 consecutive times or monitoring venous pressure\>120mmHg while maintaining 200ml/min blood flow) 4. Difficulty in puncture: A qualified nurse who has difficulty puncturing for 3 consecutive days of hemodialysis (blood can only be drawn out after more than two punctures) 5. Decreased dialysis adequacy \[arteriovenous fistula recirculation rate (RA)\>10%, or an increase of more than 25% compared to the previous examination result\] \[RA=(SA-A)/(SA-V) \* 100, dialysis to 1 hour: SA=blood flow adjusted to 20ml/min, ultrafiltration and dialysate flow stopped, after 2 minutes, artery Blood urea nitrogen concentration A=artery Blood urea nitrogen concentration V=vein Blood urea nitrogen concentration\] 6. Abnormal signs of fistula. 5. Patients with primary Hypercholesterolemia \[LDL-C ≥ 130 mg/dl (≥ 3.4 mmol/L), and/or non-HDL-C≥ 160 mg/dl (≥ 4.1 mmol/L)\] or combine cardiovascular disease or assess patients with a high risk of cardiovascular disease Exclusion Criteria: 1. MHD with AVG 2. Breastfeeding or Pregnant Women 3. Patients with central venous reflux obstruction 4. Patients with AVF feeding artery disease 5. Patients with severe Hypotension (systolic blood pressure\<90mmHg or diastolic blood pressure\<60mmHg, at least three times within one month before signing the informed consent) 6. Left ventricular Ejection fraction less than 30% or hemodynamic instability 7. Patients receiving immunotherapy or suspected/confirmed Vasculitis 8. Patients with coagulation dysfunction or a history of Thrombocytopenic purpura 9. Patients with vascular access infections or systemic active infections 10. Patients who are known to be allergic to PCSK9 inhibitors or paclitaxel 11. Patient's life expectancy is less than 12 months 12. Patients who are planning kidney transplantation or switching to Peritoneal dialysis 13. Patients participating in other intervention studies 14. The researcher judged that the subject's condition was not suitable for participation in this study