Usefulness of paclitaxel-releasing high-pressure balloon associated with cutting balloon angioplasty for treatment of outflow stenoses of failing hemodialysis arteriovenous shunts

Radiol Med. 2017 Jan;122(1):69-76. doi: 10.1007/s11547-016-0680-z. Epub 2016 Sep 6.

Abstract

Aim: To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt.

Material and methods: From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography. Angioplasty was performed with cutting balloon and afterward with PCB. The mean follow-up time was 8 months (range 6-15 months). Technical success, clinical success, primary patency and complications were registered.

Results: Technical success was 100 %. Clinical success was 94.7 %. Primary patency rate was 87.7 %; in five patients, a significant re-stenosis (≥50 %) was registered. A residual asymptomatic stenosis (<30 %) was registered in four cases (7 %). No major complications were registered.

Conclusions: A short-term patency benefit may be obtained including PCB in angioplasty treatment of failing hemodialysis arteriovenous shunts.

Keywords: Hemodialysis arteriovenous shunt; Outflow stenoses; Paclitaxel-coated balloon.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Combined Modality Therapy
  • Constriction, Pathologic
  • Female
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage*
  • Prospective Studies
  • Renal Dialysis
  • Treatment Outcome
  • Vascular Patency

Substances

  • Paclitaxel