Percutaneous transluminal angioplasty (PTA) is being performed more frequently for the treatment of stenosis in order to increase the patency of arteriovenous fistulae. This report describes a 78-year-old female who was diagnosed as having heparin-induced thrombocytopenia (HIT) just after the initiation of renal replacement therapy due to end stage diabetic nephropathy. An arteriovenous fistula was surgically created to provide permanent access for hemodialysis ; however, it failed to mature. Therefore, she underwent PTA by proximal catheterization of the fistula with the insertion of introductory sheaths and 5 mg bolus injection of argatroban. A balloon was inflated for at least 2 minutes, and this was repeated until no residual waist remained in the balloon. A final fistulogram performed 30 minutes after the initiation of PTA demonstrated complete resolution of stenosis. These observations suggest that argatroban could play a role as an alternative agent for anti-coagulation replacing heparin during PTA for hemodialysis vascular access in patients with HIT.