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The Efficacy of Paclitaxel Drug-Eluting Balloon Angioplasty Versus Standard Balloon Angioplasty in Stenosis of Native Hemodialysis Arteriovenous Fistulas: An Analysis of Clinical Success, Primary Patency and Risk Factors for Recurrent Dysfunction

  • Isil YildizEmail author
Clinical Investigation Venous Interventions
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To investigate the efficacy of paclitaxel drug-eluting balloons (PEB) versus standard balloon angioplasty (BA) in stenosis of native hemodialysis arteriovenous fistulas (AVFs).

Materials and Methods

A total of 96 patients with ESRD (mean ± SD age 57.0 ± 9.1 years, 63.5% were males) who underwent endovascular treatment with PEB angioplasty (n = 32) and BA (n = 64) for a dysfunctional native AVF were included. Clinical success, complications, primary patency and postoperative recurrence parameters were recorded in each group.

Results

Primary patency rate at 6 months was significantly higher in PEB than in BA group (96.9 vs. 20.3%, p < 0.001), while the two groups had similar primary patency rates at 9 months (66.8 vs. 50.0%) and 12 months (6.3% for each). No significant difference was noted between PEB and BA groups in terms of the rate (21.9% and. 31.3%), time (median 220 vs. 152.5 days) and reasons (reocclusion in 18.8 vs. 28.1%) for dysfunction recurrence as well as the number of recurrent treatments. AVF dysfunction recurrence was more likely in younger age AVF (median 4 vs. 23 months, p < 0.001 in PEB, and 8.5 vs. 20.5 months p = 0.001 in SBA) and in AVF ≤ 6 months in both SBA and PEB groups (71.4 vs. 12.0%, p = 0.005 in PEB, 40.0 vs. 2.3%, p < 0.001).

Conclusion

In conclusion, our findings emphasize favorable safety and efficacy of PEB and BA in the management of dysfunctional hemodialysis AVFs with similar rates of post-PTA recurrence of AVF dysfunction. Nonetheless, there was a nonsignificant tendency for lower rate and a delay for recurrent dysfunction in patients treated with PEB and a significant association younger AVF age with an increased risk of post-PTA recurrence of AVF dysfunction.

Level of Evidence

3, Retrospective cohort study.

Keywords

Paclitaxel drug-eluting balloon angioplasty Standard balloon angioplasty Hemodialysis Arteriovenous fistula Clinical success Primary patency Recurrent dysfunction 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Consent for Publication

While the present study was exempt from the requirement of ethical approval in relation to its retrospective design, the permission was obtained from our institutional ethics committee for the use of patient data for publication purposes.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of RadiologyAcibadem University Atakent HospitalIstanbulTurkey

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