1. Drug-coated balloon angioplasty in failing haemodialysis arteriovenous shunts: 12-month outcomes in 200 patients from the Aperto Italian registry
- Author
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Carbonari L, Comelli S, Savio D, Ebrahimi R, Gabriele Piffaretti, Di Maggio L, Matteo Tozzi, Palermo, Maria Cristina Cervarolo, Federico Fontana, Marco Franchin, and Filippo Piacentino
- Subjects
Adult ,Male ,medicine.medical_specialty ,arteriovenous fistulas ,Drug coated balloon ,Time Factors ,medicine.medical_treatment ,030232 urology & nephrology ,neointimal hyperplasia ,030204 cardiovascular system & hematology ,Balloon ,arteriovenous graft ,Venous stenosis ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,Arteriovenous Shunt, Surgical ,Coated Materials, Biocompatible ,Recurrence ,Renal Dialysis ,Risk Factors ,Angioplasty ,medicine ,Vascular Patency ,Humans ,Prospective Studies ,Registries ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Drug-coated balloon angioplasty ,Graft Occlusion, Vascular ,Cardiovascular Agents ,Equipment Design ,Middle Aged ,Biocompatible material ,Surgery ,Treatment Outcome ,Italy ,Nephrology ,Female ,Arteriovenous grafts ,business ,Angioplasty, Balloon ,Vascular Access Devices - Abstract
Background: We evaluated the safety and technical and clinical outcomes of angioplasty with a drug-coated balloon for the management of venous stenosis in arteriovenous grafts and arteriovenous fistulas in patients undergoing haemodialysis. Methods: Data were obtained from an ongoing prospective, non-randomised registry conducted at three Italian centres. Patients were treated with a drug-coated balloon according to standard procedures in each participating centre. Evaluation was by colour Doppler imaging every 3 months. The primary end-point was primary assisted patency. The secondary end-point was the rate of assisted patency of the vascular access. Results: A total of 311 angioplasty procedures in 200 patients, (60.4% male), were analysed. The procedural success rate was 100%. A total of 192 treatments of restenosis were necessary in 81 patients during average 21 ± 8 months follow-up. Kaplan–Meier estimates indicated that 88.0%, 64.2% and 40.6% of treated lesions were free from restenosis at 6, 12 and 24 months, respectively. Including multiple angioplasty, circuit patency rates were 99.2%, 92.5% and 84.8% at 6, 12 and 24 months, respectively. Primary patency rates were highest in shunts treated de novo with drug-coated balloons. Risk of restenosis was associated with circuit age (p = 0.017), history of treatment with conventional angioplasty (p Conclusion: The results suggest that favourable long-term patency rates can be achieved with the drug-coated balloon in a varied population of patients with failing haemodialysis arteriovenous shunts treated under conditions of actual care.
- Published
- 2019