Chi-Cheng Lai1, Hua-Chang Fang2, Ching-Jiunn Tseng3, Chun-Peng Liu4, Guang-Yuan Mar5. 1. Cardiovascular Center, Kaohsiung Veterans General Hospital, #386 Ta-Chung First Road, Kaohsiung, Taiwan 813-62; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung; School of Medicine, National Yang-Ming University, Taipei. 2. Department of Nephrology, Kaohsiung Veterans General Hospital, #386 Ta-Chung First Road, Kaohsiung, Taiwan 813-62; School of Medicine, National Yang-Ming University, Taipei. 3. Medical Education and Research, Kaohsiung Veterans General Hospital, #386 Ta-Chung First Road, Kaohsiung, Taiwan 813-62; School of Medicine, National Yang-Ming University, Taipei. 4. Department of Internal Medicine, Kaohsiung Veterans General Hospital, #386 Ta-Chung First Road, Kaohsiung, Taiwan 813-62; School of Medicine, National Yang-Ming University, Taipei. 5. Cardiovascular Center, Kaohsiung Veterans General Hospital, #386 Ta-Chung First Road, Kaohsiung, Taiwan 813-62; College of Health and Nursing, Meiho University, Pingtung, Taiwan. Electronic address: philipmar0119@gmail.com.
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.
RCT Entities:
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.
Authors: William G Sanders; Huan Li; Ilya Zhuplatov; Yuxia He; Seong-Eun Kim; Alfred K Cheung; Jayant Agarwal; Christi M Terry Journal: J Control Release Date: 2017-09-01 Impact factor: 9.776
Authors: Narayan Karunanithy; Irene Rebollo Mesa; Anthony Dorling; Francis Calder; Konstantinos Katsanos; Vikki Semik; Emily Robinson; Janet Peacock; Neelanjan Das; Colin Forman; Sarah Lawman; Kate Steiner; C Jason Wilkins; Michael G Robson Journal: Trials Date: 2016-05-12 Impact factor: 2.279