Endovascular Treatment of Haemodialysis Arteriovenous Fistula with Drug-Coated Balloon Angioplasty: A Single-Centre Study.

Abstract

To evaluate the effect of percutaneous transluminal angioplasty (PTA) on haemodialysis fistulas utilising drug-coated balloons with plain balloon vessel preparation (DCB). In the study group, 31 patients (16 men; mean age 62.8 ± 17.2years) with failing arteriovenous fistulas were treated, with DCB, and compared with a control group (31 patients; 15 men; mean age 67.0 ± 8.44years), in which only plain balloon PTA was performed. All stenoses were dilated with regular PTA balloons. After achieving haemodynamic success (< 30% residual stenosis), drug-coated balloons were used for drug administration in the study group. The follow-up intervals were 6, 12 and 24months. Target lesion primary patency, primary assisted patency and secondary patency were compared. The statistical significance was set at 0.05. Target lesion primary patency was compared in both groups and was significantly higher in the study group (DCB) at 6months (90.3 vs. 61.3%; p = 0.016), 12months (77.4 vs. 29%; p = 0.0004) as well as 24months (45.2 vs. 16.1%; p = 0.026). Kaplan-Meier survival curves also showed a significant difference for target lesion primary patency (534.2 vs. 315.7days; p = 0.0004). There were no significant differences in target lesion primary assisted patency and in secondary patency. However, only 38.7% of patients in the study group were treated twice or more versus 80.6% in the control group (p = 0.002). DCB increases target lesion primary patency during the first 24months and decreases the rate of reinterventions.