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- Title
Treatment of restenosis in radiocephalic arteriovenous hemodialysis fistulas: percutaneous transluminal angioplasty or drug-coated balloon.
- Authors
Haave, Tina R; Manstad-Hulaas, Frode; Brekken, Reidar
- Abstract
Background: Percutaneous transluminal angioplasty (PTA) is an established treatment of arteriovenous fistula (AVF) stenosis. Drug-coated balloons (DCB) are coated with an antiproliferative drug intended to decrease neointimal hyperplasia and restenosis. Purpose: To investigate the patency after treatment of restenosis in radiocephalic AVFs with PTA versus DCB. Material and Methods: A retrospective study comprising 26 patients, recruited from treatment registers, receiving at least one previous PTA and a re-intervention (13 PTAs and 13 DCBs) at the same anatomic location, were observed for 24 months. Patency after re-intervention was compared between the two cohorts. Furthermore, an intra-subject analysis, comparing patency before and after DCB, was performed in the DCB cohort. The Kaplan–Meier method was used to estimate the proportion of stenosis-free patients at different time points after treatment. Results: After 12 and 24 months, the estimated proportions of stenosis-free patients were 61% and 31%, respectively, in the DCB cohort, compared to 40% and 15% in the PTA cohort. In the intra-subject analysis, 15% and 8% of the patients treated with PTA remained stenosis-free after 12 and 24 months, respectively. Patients treated with DCB had significantly longer patency than patients in the PTA cohort (median 16 vs. 5 months, respectively; P = 0.05). Additionally, in the intra-subject analysis, patency after DCB treatment exceeded PTA (median 16 vs. 5 months, respectively; P = 0.01). Conclusion: Our results indicate that DCB angioplasty is associated with significantly improved patency in the treatment of restenosis in radiocephalic AVFs. A longer follow-up or randomized controlled trial is warranted.
- Subjects
PRETORIA (South Africa); TRANSLUMINAL angioplasty; ARTERIOVENOUS fistula; ANGIOPLASTY; SURGICAL arteriovenous shunts; URINARY fistula; HEMODIALYSIS; DISEASE relapse; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
Acta Radiologica, 2019, Vol 60, Issue 11, p1584
- ISSN
0284-1851
- Publication type
journal article
- DOI
10.1177/0284185119838173