Prospective, randomized study of cutting balloon angioplasty versus conventional balloon angioplasty for the treatment of hemodialysis access stenoses

Abstract

Cutting balloon angioplasty proved to be a safe and effective treatment of graft-to-vein anastomotic stenosis, with significantly higher patency than that of conventional balloon angioplasty.

Monocyte Chemoattractant Protein-1 Levels and Postangioplasty Restenosis of Arteriovenous Fistulas

“…In addition, the inflammatory response triggered by interventions may be another predictor of restenosis. Consequently, modification of devices or techniques to limit vessel injury, such as cutting balloons or graft stents, may be beneficial in mitigating restenosis after PTA of AVFs (26,27,38,39).…”

Comparison of Cutting Balloon Angioplasty and Percutaneous Balloon Angioplasty of Arteriovenous Fistula Stenosis

“…concluded that treatment of hemodialysis access stenoses with percutaneous cutting balloon angioplasty resulted in higher long‐term patency at 6 months compared to conventional balloon angioplasty . However, considerable heterogeneity between the patient populations of the three included studies warrants re‐considering this conclusion …”

“…compared cutting and high‐pressure balloon angioplasty exclusively in patients with AV grafts, not AV fistulas. The title of Agarwal et al 's study uses ‘arteriovenous fistula’ which could be considered misleading when patients with AV grafts are included in two of the studies …”

“…1 However, considerable heterogeneity between the patient populations of the three included studies warrants re-considering this conclusion. [2][3][4] Saleh et al's study cohort was made up of an undisclosed ratio of patients with arteriovenous (AV) fistulae and AV grafts 2 who were grouped together for analysis. These access types should be compared separately due to their well-established differences in patency profiles with AV grafts requiring more frequent interventions to maintain patency.…”

“…The title of Agarwal et al's study uses 'arteriovenous fistula' which could be considered misleading when patients with AV grafts are included in two of the studies. 1,2,4 In summary, Agarwal et al identified several limitations including differences in assessment of patency, definitions of procedural success and length of follow up. 1 However, we believe the most important limitation is the considerable heterogeneity between (and within) each of the patient populations in the three studies, specifically access type (AV fistulas versus AV grafts) and selection of resistant stenosis.…”