The angioplasty of dialysis arteriovenous fistula by drug eluting balloon versus conventional balloon angioplasty
Abstract
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.
Num-ber 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.