Randomized Clinical Trial of Cutting Balloon Angioplasty versus High-Pressure Balloon Angioplasty in Hemodialysis Arteriovenous Fistula Stenoses Resistant to Conventional Balloon Angioplasty

Aftab, Syed Arafat; Tay, Kiang Hiong; Irani, Farah Gillan; Lo, Richard Hoau Gong; Gogna, Apoorva; Haaland, Benjamin; Tan, Seck Guan; Chng, Siew Ping; Pasupathy, Shanker; Choong, Hui Lin; Tan, Bien Soo

doi:10.1016/j.jvir.2013.10.020

Cited by 86 publications

(60 citation statements)

References 25 publications

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“…Within two prospective studies (3,15) that examined stenosis at the venous anastomosis for prosthetic grafts, 6-month access circuit primary patency was 20%-36.3%, which is comparable to our patency rates. Also, for autogenous fistulas, 6-month primary patency rates range 40%-57% (14,16,17), which indicated that no major deviation in our patency outcomes occurred compared with other studies that evaluated PTA for other purposes. The observed significantly poorer patency rates of brachiocephalic fistulas compared with radiocephalic fistulas was consistent with previously published studies (14,17).…”

mentioning

confidence: 56%

Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

Rajan¹,

Sidhu²,

Noël-Lamy³

et al. 2016

Radiology

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Purpose To qualify and quantify elastic recoil and determine its effect on access patency. Materials and Methods Research ethics board approval was obtained and all patients signed an informed consent form. This was a prospective, nonrandomized study of mature accesses that underwent balloon percutaneous transluminal angioplasty (PTA) between January 2009 and December 2012. After PTA, completion fistulography was performed at 0-, 5-, 10-, and 15-minute intervals. From Digital Imaging and Communications in Medicine images, percentage of lesion stenosis before and after PTA was measured at each time point. A total of 76 patients (44 men, 32 women; mean age, 59.6 years) were enrolled and underwent 154 PTAs in 56 grafts and 98 fistulas. Venous elastic recoil was defined as recurrent luminal narrowing greater than 50% within 15 minutes after full effacement of the stenosis by the angioplasty balloon. Data collected included sex, age, access type and location, lesion location, length, and time to next intervention. Access patency was estimated by using Kaplan-Meier survival method, association of variables with the risk of loss of patency was assessed by using a Cox proportional hazards model, and a multiple variable model was examined by considering all variables. Results Technical success of PTA with less than 30% residual stenosis was 78%. By 15 minutes, 15.6% (24 of 154) of treated lesions recurrently narrowed by more than 50%, with a majority observed at 5 minutes (15 of 24). Technical failure of PTA was predictive of elastic recoil (P < .001), as was cephalic arch stenosis in fistulas (P = .047) and autogenous fistulas (P = .04). Elastic recoil, when it did occur, did not influence patency. Six-month primary patency was 34.8% in grafts and 47.1% in fistulas. Conclusion Venous elastic recoil after PTA of stenoses in hemodialysis access circuits is common, but its occurrence does not influence access primary patency after PTA. (©) RSNA, 2015.

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confidence: 56%

Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

Rajan¹,

Sidhu²,

Noël-Lamy³

et al. 2016

Radiology

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“…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).…”

Section: Discussionmentioning

confidence: 99%

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

Chen²,

Hsieh

et al. 2016

CJASN

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“…Multiple published studies, and the SIR reporting guidelines in dialysis interventions, define technical or anatomic success of percutaneous transluminal angioplasty (PTA) as \30 % residual stenosis following balloon angioplasty [1][2][3][4][5][6]. This endpoint that was initially adopted by three papers from the anatomic criteria used for arterial angioplasty [7][8][9]; however, there is a relative paucity of data validating its use for venous angioplasty in hemodialysis accesses.…”

Section: Introductionmentioning

confidence: 99%

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

Sidhu

Tan

Noël-Lamy

et al. 2016

Cardiovasc Intervent Radiol

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Randomized Clinical Trial of Cutting Balloon Angioplasty versus High-Pressure Balloon Angioplasty in Hemodialysis Arteriovenous Fistula Stenoses Resistant to Conventional Balloon Angioplasty

Cited by 86 publications

References 25 publications

Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

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

Does Technical Success of Angioplasty in Dysfunctional Hemodialysis Accesses Correlate with Access Patency?

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