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Drug-Eluting Balloon Angioplasty for Juxta-Anastomotic Stenoses in Distal Radiocephalic Hemodialysis Fistulas: Long-Term Patency Results

Authors
  • Gulcu, Aytac1
  • Sarioglu, Orkun1
  • Peker, Ahmet1
  • Alatas, Ozkan1
  • 1 Dokuz Eylul University, Department of Radiology, Faculty of Medicine, Mithatpasa Cad., Inciralti, Izmir, 35340, Turkey , Izmir (Turkey)
Type
Published Article
Journal
CardioVascular and Interventional Radiology
Publisher
Springer-Verlag
Publication Date
Mar 29, 2019
Volume
42
Issue
6
Pages
835–840
Identifiers
DOI: 10.1007/s00270-019-02213-w
Source
Springer Nature
Keywords
License
Yellow

Abstract

PurposeTo evaluate long-term primary and secondary patency results of drug-eluting balloon angioplasty for the treatment of juxta-anastomotic stenoses in distal radiocephalic arteriovenous fistulas.Materials and MethodsThirty-eight patients with juxta-anastomotic stenotic distal radiocephalic arteriovenous fistulas who underwent endovascular treatment with drug-eluting balloons between January 2014 and August 2016 in our interventional radiology department were included in this retrospective study. Color Doppler examination for follow-up was performed 15 days, 6 months, 12 months, 18 months, 24 months, 36 months, and 48 months after the procedure. Kaplan–Meier analysis was used to estimate primary and secondary patency rates.ResultsTotally, 42 angioplasty with drug-eluting balloons was performed in 38 patients (20 men and 18 women; mean age 66.42 ± 12.01). Technical and clinical success rate was 100% (42/42). The mean follow-up period was 27.71 months ± 12.98 (range, 1–54 months). The estimated primary patency rates at 6 months were 94.7% (95% CI, 80.9%–99.0%), at 12 months were 81.2% (95% CI, 64.6%–91.4%), at 24 months were 60.7% (95% CI, 43.6%–75.7%), and at 48 months were 53.1% (95% CI, 36.5%–69.1%). The estimated secondary patency rates at 6 months were 97.3% (95% CI, 84.5%–99.8%), at 12 months were 86.5% (95% CI, 70.7%–94.8%), at 24 months were 69.0% (95% CI, 51.8%–82.4%), and at 48 months were 61.7% (95% CI, 44.6%–76.5%).ConclusionDrug-eluting balloon angioplasty is a useful, effective technique in dysfunctional radiocephalic fistulas due to juxta-anastomotic stenoses. We demonstrated remarkably high primary patency rates at 6, 12, 24, and 48 months.

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