Abstract No. 635 Drug-eluting balloon angioplasty in the treatment of renal dialysis arteriovenous fistula stenosis

Abstract

Stenosis is a common complication of renal dialysis arteriovenous (AV) fistulas, leading to poor maturation, thrombosis, and loss of haemodialysis access. [1] Recent studies propose the use of drug-eluting balloon (DEB) over standard balloon angioplasty (POBA) for AV fistula stenosis. [2] We report our experience in terms of safety and efficacy of using DEB angioplasty for the treatment of AV fistula stenosis. A retrospective study was conducted of 23 patients (14 male; mean age 72.3 ± 14.0) with 26 AV fistula stenoses that were treated with a Paclitaxel-eluting balloon. Four stenotic lesions were de novo, whereas the majority were re-stenosis following POBA. Immediate post-angioplasty technical success and complications are reported. A crossover design analysis was used to assess the intervention-free period following DEB angioplasty compared to POBA in patients with re-stenosis. Technical success was 100% in DEB treated stenoses. No immediate complications occurred. Thirteen (50%) DEB treated stenoses were intervention-free at analysis (mean follow-up 11.1 ± 5.1 months). Remaining DEB treated lesions were intervention-free for a mean duration of 6.1 ± 3.1 months. The proportion of DEB treated stenoses free from intervention was comparable to POBA at three months (95% vs. 91%; p-value = n.s). A significantly greater proportion of DEB treated lesions was intervention-free at six months (50% vs. 18%; p-value = 0.039) and nine months (53%vs.18%; p-value = 0.031). A higher proportion of DEB treated lesions was intervention-free at 12 months (22% vs. 9%; p-value = n.s.). Drug-eluting balloon angioplasty appears feasible and safe for the treatment of AV fistula stenosis and seems to be associated with a longer intervention-free period compared to standard angioplasty. Further prospective randomised trials are warranted.