Anna Maria Ierardi1, Marco Franchin2, Federico Fontana1, Gabriele Piffaretti2, Ejona Duka1, Massimo Tonolini3, Vittorio Miele4, Matteo Tozzi2, Gianpaolo Carrafiello5. 1. Interventional Radiology, Department of Radiology, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy. 2. Vascular Surgery Department, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy. 3. Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan (MI), Italy. 4. Department of Emergency Radiology, S. Camillo Hospital, Circonvallazione Gianicolense, 87, 00152, Rome, Italy. 5. Diagnostic and Interventional Radiology Unit, Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy. gcarraf@gmail.com.
Abstract
AIM: To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt. MATERIAL AND METHODS: From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography. Angioplasty was performed with cutting balloon and afterward with PCB. The mean follow-up time was 8 months (range 6-15 months). Technical success, clinical success, primary patency and complications were registered. RESULTS: Technical success was 100 %. Clinical success was 94.7 %. Primary patency rate was 87.7 %; in five patients, a significant re-stenosis (≥50 %) was registered. A residual asymptomatic stenosis (<30 %) was registered in four cases (7 %). No major complications were registered. CONCLUSIONS: A short-term patency benefit may be obtained including PCB in angioplasty treatment of failing hemodialysis arteriovenous shunts.
AIM: To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt. MATERIAL AND METHODS: From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography. Angioplasty was performed with cutting balloon and afterward with PCB. The mean follow-up time was 8 months (range 6-15 months). Technical success, clinical success, primary patency and complications were registered. RESULTS: Technical success was 100 %. Clinical success was 94.7 %. Primary patency rate was 87.7 %; in five patients, a significant re-stenosis (≥50 %) was registered. A residual asymptomatic stenosis (<30 %) was registered in four cases (7 %). No major complications were registered. CONCLUSIONS: A short-term patency benefit may be obtained including PCB in angioplasty treatment of failing hemodialysis arteriovenous shunts.
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