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Endovascular Treatment of Haemodialysis Arteriovenous Fistula with Drug-Coated Balloon Angioplasty: A Single-Centre Study

Abstract

Purpose

To evaluate the effect of percutaneous transluminal angioplasty (PTA) on haemodialysis fistulas utilising drug-coated balloons with plain balloon vessel preparation (DCB).

Materials and Methods

In the study group, 31 patients (16 men; mean age 62.8 ± 17.2 years) with failing arteriovenous fistulas were treated, with DCB, and compared with a control group (31 patients; 15 men; mean age 67.0 ± 8.44 years), in which only plain balloon PTA was performed. All stenoses were dilated with regular PTA balloons. After achieving haemodynamic success (< 30% residual stenosis), drug-coated balloons were used for drug administration in the study group. The follow-up intervals were 6, 12 and 24 months. Target lesion primary patency, primary assisted patency and secondary patency were compared. The statistical significance was set at 0.05.

Results

Target lesion primary patency was compared in both groups and was significantly higher in the study group (DCB) at 6 months (90.3 vs. 61.3%; p = 0.016), 12 months (77.4 vs. 29%; p = 0.0004) as well as 24 months (45.2 vs. 16.1%; p = 0.026). Kaplan–Meier survival curves also showed a significant difference for target lesion primary patency (534.2 vs. 315.7 days; p = 0.0004). There were no significant differences in target lesion primary assisted patency and in secondary patency. However, only 38.7% of patients in the study group were treated twice or more versus 80.6% in the control group (p = 0.002).

Conclusion

DCB increases target lesion primary patency during the first 24 months and decreases the rate of reinterventions.

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Acknowledgements

This work was previously presented as an electronic poster (P-114) during CIRSE 2017 meeting in Copenhagen, September 16–20 and as oral scientific presentation (B-0864) during the European Congress of Radiology (ECR) 2018 in Vienna, February 28–March 4.

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Correspondence to Jernej Lučev.

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The authors declare that 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.

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The authors declare that informed consent was obtained from all individual participants included in the study.

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Lučev, J., Breznik, S., Dinevski, D. et al. Endovascular Treatment of Haemodialysis Arteriovenous Fistula with Drug-Coated Balloon Angioplasty: A Single-Centre Study. Cardiovasc Intervent Radiol 41, 882–889 (2018). https://doi.org/10.1007/s00270-018-1942-z

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Keywords

  • Haemodialysis fistula
  • Percutaneous transluminal angioplasty
  • Drug-coated balloon
  • Vessel preparation
  • Paclitaxel