The Relationship Between Neutrophil–Lymphocyte Ratio and Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Arteriovenous Fistula Stenosis When Using Conventional and Drug-Eluting Balloons
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The aim of this study is to investigate the potential association of neutrophil–lymphocyte ratio (NLR) between primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula stenosis and type (Conventional and Drug-Eluting) of balloons used in PTA.
This retrospective study consists of 78 patients with significant arteriovenous fistulas stenosis who were treated with PTA by using Drug-Eluting Balloon (DEB) (n = 29) or Conventional Balloon (CB) (n = 49). NLR was calculated from preinterventional blood samples. All patients were classified into two groups. Group A; primary patency <12 months (43/78), Group B; primary patency ≥12 months (35/78). Cox regression analysis and Kaplan–Meier method were used to determine respectively independent factors affecting the primary patency and to compare the primary patency for the two balloon types.
NLR ratio and balloon type of the two groups were significantly different (p = 0.002, p = 0.010). The cut-off value of NLR was 3.18 for determination of primary patency, with sensitivity of 81.4 % and specificity of 51.4 %. Primary patency rates between PTA with DEB and CB displayed statistically significant differences (p < 0.05). The cut-off value was 3.28 for determination of 12-month primary patency with the conventional balloon group; sensitivity was 81.8 % and specificity was 81.3 %. There was no statistical relation between NLR levels and the drug-eluting balloon group in 12-month primary patency (p = 0.927).
Increased level of NLR may be a risk factor in the development of early AVF restenosis after successful PTA. Preferring Drug-Eluting Balloon at an increased level of NLR can be beneficial to prolong patency.
KeywordsArteriovenous fistula Conventional balloon angioplasty Drug-eluting balloon angioplasty Neutrophil–Lymphocyte ratio Primary patency Restenosis
Compliance with Ethical Standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective type of study formal consent is not required.
- 1.Kazemzadeh GH, Modaghegh MHS, Ravari H, Daliri M, Hoseini L, Nataghi M. Primary patency rate of native AV fistula: long term follow up. Int J Clin Exp Med. 2012;5:173–8.Google Scholar
- 2.III. NKF-K/DOQI Clinical practice guidelines for vascular access: update 2000. Am J Kidney Dis. 2001; 37:S137–81.Google Scholar
- 13.Kitrou P, Spiliopoulos S, Katsanos K, Papachristou E, Siablis Karnabatidis D. Paclitaxel-coated balloon angioplasty versus plain balloon angioplasty for dysfunctional arteriovenous fistulae: 1 year results of a prospective randomized controlled trial. J Vasc Interv Radiol. 2015;26:348–54.CrossRefPubMedGoogle Scholar
- 31.Scheinert D, Duda S, Zeller T, et al. TheLEVANT I (Lutonix paclitaxel-coated balloon for the prevention of femoropopliteal restenosis) trial for femoropopliteal revascularization: first-inhuman randomized trial of low-dose drug-coated balloon versus uncoated balloon angioplasty. J Am Coll Cardiol Intv. 2014;7:10–9.CrossRefGoogle Scholar