Systematic Review of Drug Eluting Balloon Angioplasty for Arteriovenous Haemodialysis access Stenosis

Khawaja, Aurangzaib; Cassidy, Deirdre; Shakarchi, Julien Al; McGrogan, Damian; Inston, Nicholas; Jones, Robert G.

doi:10.5301/jva.5000508

Cited by 58 publications

(51 citation statements)

References 47 publications

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“…Kitrou et al showed a numerical improvement with paclitaxel coated balloon angioplasty compared to plain angioplasty but there was no statistical significance in outcome; however, there were only 7 patients in each group [205]. A meta-analysis of 6 studies, 2 RCT and 4 cohort studies, reported encouraging 6-month patency with drug eluting balloon angioplasty (70–97% vs. 0–26%), although in these studies the numbers of patients were small and heterogeneous [206]. Infection also remains a concern for paxlitaxel [207].…”

Section: Future Approaches To Treatmentmentioning

confidence: 99%

Future research directions to improve fistula maturation and reduce access failure

Patel

Hänisch

et al. 2016

Seminars in Vascular Surgery

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With the increasing prevalence of end stage renal disease there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes, in the setting of uremia, systemic inflammation, oxidative stress and preexistent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis, as well as development of neointimal hyperplasia (NIH) that narrows the AVF lumen, typically near the fistula anastomosis. Failure due to NIH involves vascular cell activation and migration and extracellular matrix remodeling with complex interactions of growth factors, adhesion molecules, inflammatory mediators, and chemokines, all of which result in maladaptive remodeling. Different strategies have been proposed to prevent and treat AVF failure, based on current understanding of the modes and pathology of access failure; these approaches range from appropriate patient selection and use of alternative surgical strategies for fistula creation, to the use of novel interventional techniques or drugs to treat failing fistulae. Effective treatments to prevent or treat AVF failure requires a multidisciplinary approach involving nephrologists, vascular surgeons and interventional radiologists, allowing careful patient selection and the use of tailored systemic or localized interventions to improve patient-specific outcomes. This review provides contemporary information on the underlying mechanisms of AVF maturation and failure and discusses the broad spectrum of options that can be tailored for specific therapy.

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Section: Future Approaches To Treatmentmentioning

confidence: 99%

Future research directions to improve fistula maturation and reduce access failure

Patel

Hänisch

et al. 2016

Seminars in Vascular Surgery

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“… 41 , 42 ) The efficacy of DCBs in arteriovenous hemodialysis access in hemodialysis patients has been reported, which found that DCBs significantly improved patency compared to balloon therapy. 43 ) However, arteriovenous access disease does not generally include severely calcified lesions such as those observed with coronary artery disease in hemodialysis patients. Application of DCBs for coronary artery disease has not been reported in hemodialysis patients.…”

Section: Percutaneous Coronary Interventionmentioning

confidence: 99%

Cardiovascular Disease in Patients with End-Stage Renal Disease on Hemodialysis

Aoki

Ikari

2017

Annals of Vascular Diseases

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Cardiovascular disease is a major concern for patients with end-stage renal disease (ESRD), especially those on hemodialysis. ESRD patients with coronary artery disease often do not have symptoms or present with atypical symptoms. Coronary lesions in ESRD patients are characterized by increased media thickness, infiltration and activation of macrophages, and marked calcification. Several studies showed worsened clinical outcomes after coronary revascularization, which were dependent on the severity of renal dysfunction. ESRD patients on hemodialysis have the most severe renal dysfunction; thus, the clinical outcomes are worse in these patients than in those with other types of renal dysfunction. Medications for primary or secondary cardiovascular prevention are also insufficient in ESRD patients. Efficacy of drug-eluting stents is inferior in ESRD patients, compared to the excellent outcomes observed in patients with normal renal function. Unsatisfactory outcomes with trials targeting cardiovascular disease in patients with ESRD emphasize a large potential to improve outcomes. Thus, optimal strategies for diagnosis, prevention, and management of cardiovascular disease should be modified in ESRD patients.

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“…Reduction of hemodialysis circuit patency is most commonly caused by venous intimal hyperplasia (70), which may be the result of several upstream events, such as surgical trauma at the time of access creation, inflammation, uremia, hypoxia, hemodynamic shear stress, and vessel wall injury from needle punctures, as well as downstream events, including cellular mechanisms leading to increased leukocyte proliferation, smooth muscle cell migration from the media to the intimal layer, and eventual stenosis (71,72). Despite advances in the understanding of the pathogenesis of neointimal hyperplasia, the role and efficacy of adjunct interventions, such as drug-eluting balloons and stents, systemic pharmacologic agents, perivascular drug therapies, and cellular and gene therapies in treating dysfunctional hemodialysis circuits, theories and treatments continue to evolve (73)(74)(75)(76)(77)(78)(79).…”

Section: Introductionmentioning

confidence: 99%

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

Dariushnia

Walker

Silberzweig

et al. 2016

Journal of Vascular and Interventional Radiology

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AR = access recirculation, AVF = arteriovenous fistula, AVG = arteriovenous graft, DHIS = distal hypoperfusion ischemia syndrome, KDOQI = Kidney Disease Outcomes Quality Initiative, NKF = National Kidney Foundation, Qa = blood access flow rate PREAMBLE The membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from both the private and the academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production. Technical documents specifying the exact consensus and literature review methodologies as well as the institutional affiliations and professional credentials of the authors of this document are available upon request from SIR, 3975 Fair Ridge Dr, Ste 400 North, Fairfax, VA 22033. METHODOLOGY SIR produces its Standards of Practice documents using the following process. Standards documents of relevance and timeliness are conceptualized by the Standards of Practice Committee members. A recognized expert is identified to serve as the principal author for the standard. Additional authors may be assigned depending on the magnitude of the project. An in-depth literature search is performed using electronic medical literature databases. Then a critical review of peer-reviewed articles is performed with regard to the study methodology, results, and conclusions. The qualitative weight of these articles is assembled into an evidence table, which is used to write the document such that it contains evidence-based data with respect to content, rates, and thresholds. When the evidence of literature is weak, conflicting, or contradictory, consensus for the parameter is reached by a minimum of 12 Standards of Practice Committee members using a Modified Delphi Consensus Method (Appendix A). For purposes of these documents, consensus is defined as 80% Delphi participant agreement on a value or parameter. The draft document is critically reviewed by the Revisions Subcommittee members of the Standards of Practice Committee, either by telephone conference calling or by face-to-face meeting. The finalized draft from the Committee is sent to the SIR membership for further input or criticism during a 30-day comment period. These comments are discussed by the Subcommittee, and appropriate revisions are made to create the finished standards document. Before its publication, the document is endorsed by the SIR Executive Council.

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Systematic Review of Drug Eluting Balloon Angioplasty for Arteriovenous Haemodialysis access Stenosis

Cited by 58 publications

References 47 publications

Future research directions to improve fistula maturation and reduce access failure

Future research directions to improve fistula maturation and reduce access failure

Cardiovascular Disease in Patients with End-Stage Renal Disease on Hemodialysis

Quality Improvement Guidelines for Percutaneous Image-Guided Management of the Thrombosed or Dysfunctional Dialysis Circuit

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