Percutaneous angioplasty using a paclitaxel-coated balloon improves target lesion restenosis on inflow lesions of autogenous radiocephalic fistulas: a pilot study

J Vasc Interv Radiol. 2014 Apr;25(4):535-41. doi: 10.1016/j.jvir.2013.12.014. Epub 2014 Feb 12.

Abstract

Purpose: To determine whether the use of a paclitaxel-coated balloon (PCB) improves patency in patients undergoing percutaneous transluminal angioplasty (PTA) for recurrent juxtaanastomotic stenosis of radiocephalic arteriovenous fistulas (RCAVFs).

Material and methods: This prospective study recruited hemodialysis patients with two short (< 2 cm) and separated inflow RCAVF lesions. After dilation of lesions using a 4-mm plain balloon (PB), half of the lesions were randomly selected for treatment with PTA using PCB (size, 4 mm; length, 2 cm) and PB (size, 5-mm or 6-mm) (group 1), and the other half were treated with PTA using PB alone (group 2). After the index PTA, dysfunction-driven angiography was performed to confirm target lesion restenosis (TLR). TLR and lesion patency were compared in the two groups by χ(2) test, t test, and Kaplan-Meier analysis.

Results: The analysis of 20 lesions in 10 patients revealed that the TLR-free duration in group 1 was significantly longer than the TLR-free duration in group 2 (251.2 d vs 103.2 d; P < .01). The patency rate of the target lesion was significantly higher in group 1 than in group 2 at 6 months (70% vs 0%; P < .01) but not at 12 months (20% vs 0%; P > .05).

Conclusions: This early study suggests that, for improving short-term patency, PTA with PCB and PB is more effective than PTA with PB alone, warranting further study.

Publication types

  • Comparative Study
  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Cardiovascular Agents / administration & dosage*
  • Chi-Square Distribution
  • Coated Materials, Biocompatible*
  • Female
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / physiopathology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage*
  • Pilot Projects
  • Prospective Studies
  • Radial Artery / diagnostic imaging
  • Radial Artery / physiopathology
  • Radial Artery / surgery*
  • Radiography
  • Recurrence
  • Renal Dialysis*
  • Time Factors
  • Treatment Outcome
  • Upper Extremity / blood supply*
  • Vascular Access Devices*
  • Vascular Patency

Substances

  • Cardiovascular Agents
  • Coated Materials, Biocompatible
  • Paclitaxel