The eternal tale of dialysis access vessels and restenosis: are drug-eluting balloons the solution?
The eternal tale of dialysis access vessels and restenosis: are drug-eluting balloons the solution?
Post author correction
Article Type: REVIEW
Article Subject: Interventional radiology
DOI:10.5301/jva.5000271
Authors
Rupert H. Portugaller, Peter I. Kalmar, Hannes Deutschmann
Corresponding author
- Rupert H. Portugaller
- Department of Vascular and Interventional Radiology
- Auenbruggerplatz 9A A 8036 Graz
Abstract
In dialysis access fistulas and grafts, percutaneous transluminal angioplasty (PTA) is frequently followed by restenosis development, which results in repeated periodical re-interventions. The technique of drug-eluting balloon (DEB) angioplasty has shown promising results in the treatment of femoropopliteal arteriosclerotic lesions. In contrast to arteriosclerotic arteries, dialysis access vessels host unfavorable hemodynamics due to the direct conduction of high-pressure fluid into a low-pressure system. Hence, the beneficial effect of DEB angioplasty may be limited in this system. However, a first prospective randomized trial on 40 patients with arteriovenous fistula or graft stenoses exhibited a significantly higher 6-month primary patency of the treated lesions after DEB angioplasty than after uncoated balloon angioplasty. Despite such a positive reference, general recommendations regarding the value of DEBs in dialysis access vessels cannot be considered as serious unless large randomized controlled trials have been performed.
Article History
- • Accepted on 15/04/2014
- • Available online on 08/07/2014
Disclosures
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Authors
- Portugaller, Rupert H. [PubMed] [Google Scholar] , * Corresponding Author
- Kalmar, Peter I. [PubMed] [Google Scholar]
- Deutschmann, Hannes [PubMed] [Google Scholar]
- Address for correspondence:
- Department of Vascular and Interventional Radiology
- Auenbruggerplatz 9A A 8036 Graz
- rupert.portugaller@medunigraz.at
Affiliations
- Department of Vascular and Interventional Radiology, University Clinic of Radiology, Medical University Graz (MUG), Graz - Austria