Ces radiol. 2022, 76(1):23-31 | DOI: 10.55095/CesRadiol2022/004

The angioplasty of dialysis arteriovenous fistula by drug eluting balloon versus conventional balloon angioplastyOriginal article

Martin Vorčák1,4, Kamil Zeleňák1, Ján Sýkora1, Martin Števík1, Igor Šinák2, Marián Grendár3, Antonín Krajina4
1 Radiologická klinika JLF UK a Univerzitnej nemocnice Martin, SR
2 Oddelenie cievnej chirurgie Univerzitnej nemocnice Martin, SR
3 Bioinformačné konzultačné centrum JLF UK, Martin, SR
4 Radiologická klinika LF UK a FN, Hradec Králové

Aim: The aim of our retrospective study was to evaluate primary patency of angioplasty using drug eluting balloon (DEB) and conventional balloon (PTA) in dysfunctional dialysis fistula.

Methods: Fifty eight adult patients treated for fistula dysfunction in period from 2015 to 2018 were enrolled based on following criteria - matured native fistula with stenosis above 50%. Patients with restenosis, swing point, cephalic arch and central vein stenosis and multiple distant stenoses were ruled out. Patients were divided into two groups according to received treatment - DEB and PTA. Primary patency of angioplasty was defined as the function of dialysis without the need for clinically driven endovascular or surgical intervention on culprit lesion during follow up. Secondary, dialysis access patency, 12-month assisted patency, technical, clinical success, complication rate and mortality among treated groups were evaluated.

Results: Primary patency at 6th and 12th months follow up was evaluated in 25 patients in the DEB and 25 patients in the PTA group. Primary and access patency were in DEB vs. PTA: 96% vs. 76% (p = 0.1) and 96% vs. 72% (p = 0.049) at 6 months, 80% vs. 56% (p = 0.13), 80% vs. 52% (p = 0.073) at 12 months. Assisted patency was: 96% vs. 76%, p = 0.1. Primary technical success was in DEB vs. PTA: 70% vs. 74% (p = 0.9), secondary 100% vs. 94% (p = 0.5), clinical success: 100% vs. 97% (p > 0.9), overall rate of complications 15% vs. 9.7% (p = 0.7), all but one mild. Number of interventions in access in 12 months was significantly lower in DEB group with 5 interventions compared to PTA group with 14 interventions (p = 0.02).

Conclusion: Patients treated with DEB needed significantly less interventions on access during 12-month follow-up.

Keywords: angioplasty, DEB, DCB, dialysis, fistula
Grants and funding:

Výzkum byl podpořen Grantovou agenturou Univerzity Karlovy (SVV UK, projekt LF HK č. 260544).
This publication has been produced with the support of the Integrated Infrastructure Operational Program for the project: Creation of a Digital Biobank to support the systemic public research infrastructure, ITMS: 313011AFG4, co-financed by the European Regional Development Fund.

Accepted: March 28, 2022; Published: March 1, 2022  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Vorčák M, Zeleňák K, Sýkora J, Števík M, Šinák I, Grendár M, Krajina A. The angioplasty of dialysis arteriovenous fistula by drug eluting balloon versus conventional balloon angioplasty. Ces radiol. 2022;76(1):23-31. doi: 10.55095/CesRadiol2022/004.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Quencer KB, Arici M. Arteriovenous Fistulas and Their Characteristic Sites of Stenosis. AJR Am J Roentgenol 2015; 205(4): 726-734. doi: 10.2214/AJR.15.14650 Go to original source... Go to PubMed...
    2. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis 2020; 75(4 Suppl 2): 1-164. doi: 10.1053/j.ajkd.2019.12.001 Go to original source... Go to PubMed...
    3. Greenberg JI, Suliman A, Angle N. Endovascular Dialysis Interventions in the Era of DOQI. Ann Vasc Surg 2008; 22(5): 657-662. Go to original source... Go to PubMed...
    4. Bountouris I, Kristmundsson T, Dias N, Zdanowski Z, Malina M. Is repeat PTA of a failing hemodialysis fistula durable? Int J Vasc Med 2014; 2014: 1-6. Go to original source... Go to PubMed...
    5. Miquelin D, Reis L, da Silva A, de Godoy J. Percutaneous transluminal angioplasty in the treatment of stenosis of arteriovenous fistulae for hemodialysis. Int Arch Med 2008; 1(1): 16. Go to original source... Go to PubMed...
    6. Rajan DK, Bunston S, Misra S, Pinto R, Lok CE. Dysfunctional autogenous hemodialysis fistulas: Outcomes after angioplasty - Are there clinical predictors of patency? Radiology 2004; 232(2): 508-515. Go to original source... Go to PubMed...
    7. Trerotola SO, Roy-Chaudhury P, Saad TF. Drug-Coated Balloon Angioplasty in Failing Arteriovenous Fistulas: More Data, Less Clarity. Am J Kidney Dis [Internet] 2021; 78(1): 13-5. doi.org/10.1053/j.ajkd.2021.02.331 Go to original source... Go to PubMed...
    8. Lookstein RA, Haruguchi H, Ouriel K, et al. Drug-Coated Balloons for Dysfunctional Dialysis Arteriovenous Fistulas. N Engl J Med 2020; 383: 733-742. https://doi.org/10.1056/nejmoa1914617 Go to original source... Go to PubMed...
    9. Roček M. Obnovení funkce hemodialyzačního cévního přístupu. In: Krajina A, Peregrin J, editors. Intervenční radiologie: miniinvazívní terapie. Hradec Králové: Olga Čermáková 2005; 258-268.
    10. Roy-Chaudhury P, Sukhatme VP, Cheung AK. Hemodialysis vascular access dysfunction: A cellular and molecular viewpoint. J Am Soc Nephrol 2006; 17(4): 1112-1127. Go to original source... Go to PubMed...
    11. Mezzano D, Pais E, Aranda E, et al. Inflammation, not hyperhomocysteinemia, is related to oxidative stress and hemostatic and endothelial dysfunction in uremia. Kidney Int [Internet] 2001; 60(5): 1837-1843. Available from: https://pubmed.ncbi.nlm.nih.gov/11703602/ Go to original source...
    12. Feng H, Chen X, Guo X, et al. Comparison of efficacy and safety of drug-eluting versus uncoated balloon angioplasty for femoropopliteal arterial occlusive disease: a meta-analysis. BMC Cardiovasc Disord [Internet] 2020; 20(1). Available from: https://pubmed.ncbi.nlm.nih.gov/32867681/ Go to original source... Go to PubMed...
    13. Liu L, Liu B, Ren J, et al. Comparison of drug-eluting balloon versus drug-eluting stent for treatment of coronary artery disease: a meta-analysis of randomized controlled trials. BMC Cardiovasc Disord [Internet] 2018; 18(1). Available from: /pmc/articles/PMC5834842/ Go to original source... Go to PubMed...
    14. Fisi V, Kátai E, Bogner P, Miseta A, Nagy T. Timed, sequential administration of paclitaxel improves its cytotoxic effectiveness in a cell culture model. Cell Cycle 2016; 15: 1227-1233. https://doi.org/10.1080/15384101.2016.1158361. Go to original source... Go to PubMed...
    15. Patanè D, Giuffrida S, Morale W, et al. Drug-eluting balloon for the treatment of failing hemodialytic radiocephalic arteriovenous fistulas: Our experience in the treatment of juxta-anastomotic stenoses. J Vasc Access 2014; 15(5): 338-343. Go to original source... Go to PubMed...
    16. Kitrou PM, Spiliopoulos S, Katsanos K, et al. Paclitaxel-coated versus plain balloon angioplasty for dysfunctional arteriovenous fistulae: One-year results of a prospective randomized controlled trial. J Vasc Interv Radiol 2015; 26(3): 348-354. Go to original source... Go to PubMed...
    17. Maleux G, Vander Mijnsbrugge W, Henroteaux D, et al. Multicenter, Randomized Trial of Conventional Balloon Angioplasty versus Paclitaxel-Coated Balloon Angioplasty for the Treatment of Dysfunctioning Autologous Dialysis Fistulae. J Vasc Interv Radiol [Internet] 2018; 29(4): 470-475.e3. Available from: https://doi.org/10.1016/j.jvir.2017.10.023 Go to original source... Go to PubMed...
    18. Irani FG, Teo TKB, Tay KH, et al. Hemodialysis arteriovenous fistula and graft stenoses: Randomized trial comparing drug-eluting balloon angioplasty with conventional angioplasty. Radiology 2018; 289(1): 238-247. Go to original source... Go to PubMed...
    19. Swinnen J, Hitos K, Kairaitis L, et al. Multicentre, randomised, blinded, control trial of drug-eluting balloon vs Sham in recurrent native dialysis fistula stenoses. J Vasc Access 2019; 20(3): 260-269. Go to original source... Go to PubMed...
    20. Björkman P, Weselius EM, Kokkonen T, et al. Drug-Coated Versus Plain Balloon Angioplasty In Arteriovenous Fistulas: A Randomized, Controlled Study With 1-Year Follow-Up (The Drecorest Ii-Study). Scand J Surg 2019; 108(1): 61-66. Go to original source... Go to PubMed...
    21. Liao MT, Lee CP, Lin TT, et al. A randomized controlled trial of drug-coated balloon angioplasty in venous anastomotic stenosis of dialysis arteriovenous grafts. J Vasc Surg 2020; 71(6): 1994-2003. Go to original source... Go to PubMed...
    22. Trerotola SO, Saad TF, Roy-Chaudhury P. The Lutonix AV Randomized Trial of Paclitaxel-Coated Balloons in Arteriovenous Fistula Stenosis: 2-Year Results and Subgroup Analysis. J Vasc Interv Radiol [Internet] 2020; 31(1): 1-14.e5. Available from: https://doi.org/10.1016/j.jvir.2019.08.035 Go to original source... Go to PubMed...
    23. IN.PACTTM AV Access Study - Study Results - ClinicalTrials.gov [Internet]. Available from: https://clinicaltrials.gov/ct2/show/results/NCT03041467
    24. Pang SYC, Au-Yeung KCL, Liu GYL, et al. Randomized Controlled Trial for Paclitaxel-coated Balloon versus Plain Balloon Angioplasty in Dysfunctional Hemodialysis Vascular Access: 12-month Outcome from a Nonsponsored Trial. Ann Vasc Surg [Internet] 2021; 72: 299-306. Available from: https://doi.org/10.1016/j.avsg.2020.10.005 Go to original source... Go to PubMed...
    25. Yin Y, Shi Y, Cui T, et al. Efficacy and Safety of Paclitaxel-Coated Balloon Angioplasty for Dysfunctional Arteriovenous Fistulas: A Multicenter Randomized Controlled Trial. Am J Kidney Dis [Internet] 2021; 78(1): 19-27.e1. Available from: https://doi.org/10.1053/j.ajkd.2020.11.022 Go to original source... Go to PubMed...
    26. Roček M, Peregrin JH. Percutaneous interventions for vascular dialysis access. EDTNA-ERCA J 2001; 27(2): 83-87. Go to original source... Go to PubMed...
    27. Peregrin JH, Roček M. Results of a Peripheral Cutting Balloon prospective multicenter European registry in hemodialysis vascular access. Cardiovasc Intervent Radiol 2007; 30(2): 212-215. Go to original source... Go to PubMed...
    28. Wu CC, Lin MC, Pu SY, Tsai KC, Wen SC. Comparison of Cutting Balloon versus High-Pressure Balloon Angioplasty for Resistant Venous Stenoses of Native Hemodialysis Fistulas. J Vasc Interv Radiol 2008; 19(6): 877-883. Go to original source... Go to PubMed...
    29. Aftab SA, Tay KH, Irani FG, et al. Randomized clinical trial of cutting balloon angioplasty versus high-pressure balloon angioplasty in hemodialysis arteriovenous fistula stenoses resistant to conventional balloon angioplasty. J Vasc Interv Radiol [Internet] 2014; 25(2): 190-198. Available from: http://dx.doi.org/10.1016/j.jvir.2013.10.020 Go to original source... Go to PubMed...
    30. Barath P, Fishbein MC, Vari S, Forrester JS. Cutting balloon: A novel approach to percutaneous angioplasty. Am J Cardiol 1991; 68(11): 1249-1252. Go to original source... Go to PubMed...
    31. Nassar GM, Beathard G, Rhee E, Khan AJ, Nguyen B. Management of transposed arteriovenous fistula swing point stenosis at the basilic vein angle of transposition by stent grafts. J Vasc Access 2017; 18(6): 482-487. Go to original source... Go to PubMed...
    32. McLennan G. Stent and Stent-Graft Use in Arteriovenous Dialysis Access. Semin Intervent Radiol 2016; 33(1): 10-14. Go to original source... Go to PubMed...
    33. Buriánková E, Köcher M, Bachleda P, et al. Endovascular treatment of central venous stenoses in patients with dialysis shunts. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2003; 147(2): 203-206. Go to original source... Go to PubMed...
    34. Martin LG, MacDonald MJ, Kikeri D, et al. Prophylactic angioplasty reduces thrombosis in virgin ePTFE arteriovenous dialysis grafts with greater than 50% stenosis: Subset analysis of a prospectively randomized study. J Vasc Interv Radiol 1999; 10(4): 389-396. Go to original source... Go to PubMed...
    35. Neuen BL, Gunnarsson R, Baer RA, et al. Factors associated with patency following angioplasty of hemodialysis fistulae. J Vasc Interv Radiol [Internet] 2014; 25(9): 1419-1426. Available from: http://dx.doi.org/10.1016/j.jvir.2014.05.020 Go to original source... Go to PubMed...
    36. Lok CE, Sontrop JM, Tomlinson G, et al. Cumulative patency of contemporary fistulas versus grafts (2000-2010). Clin J Am Soc Nephrol 2013; 8(5): 810-818. Go to original source... Go to PubMed...
    37. Patanè D, Failla G, Coniglio G, et al. Treatment of juxta-anastomotic stenoses for failing distal radiocephalic arteriovenous fistulas: Drug-coated balloons versus angioplasty. J Vasc Access 2019; 20: 209-216. https://doi.org/10.1177/1129729818793102 Go to original source... Go to PubMed...
    38. Chen X, Liu Y, Wang J, et al. A systematic review and meta-analysis of the risk of death and patency after application of paclitaxel-coated balloons in the hemodialysis access. J Vasc Surg 2020; 72(6): 2186-2196.e3. Go to original source... Go to PubMed...
    39. Dinh K, Limmer AM, Paravastu SCV, et al. Mortality After Paclitaxel-Coated Device Use in Dialysis Access: A Systematic Review and Meta-Analysis. J Endovasc Ther [Internet] 2019; 26(5): 600-612. Available from: https://doi.org/10.1177/1526602819872154 Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content