Paclitaxel-Coated Balloon Angioplasty Studied to Treat Dysfunctional Arteriovenous Fistulas

March 12, 2015—One-year results of a single-center prospective randomized controlled trial comparing a paclitaxel-coated balloon (PCB) versus high-pressure plain balloon (HPB) angioplasty for the treatment of failing arteriovenous fistulas (AVFs) were reported by Panagiotis M. Kitrou, MD, et al in the Journal of Vascular and Interventional Radiology (JVIR; 2015;26:348–354).

As reported in JVIR, the investigators of this single-center study found that the use of PCBs resulted in superior target lesion revascularization (TLR)-free survival and dialysis access circuit primary patency of dysfunctional AVFs. However, additional HPB postdilation was required in the majority of cases.

The study randomized 40 patients at 1:1 to undergo PCB or HPB angioplasty of dysfunctional AVFs. There were no significant differences in baseline demographics between groups. Enrollment required a clinical diagnosis of a dysfunctional AVF attributed to a single stenotic lesion verified with digital subtraction angiography. Primary endpoints included device success, anatomic success, clinical success, and TLR-free survival. Secondary endpoints included dialysis circuit primary patency and procedure-related complication rates.

Device success rates were 100% in the HPB group and 35% in the PCB group: further dilation with an HPB was needed to achieve anatomic success in 13 of 20 cases in the PCB group. Anatomic and clinical success rates were 100% in both groups. TLR-free survival and access circuit primary patency were significantly in favor of PCB angioplasty. No minor or major procedure-related complications occurred, reported the investigators in JVIR.