Cutting Balloon Angioplasty for Resistant Venous Stenoses of Brescia-Cimino Fistulas

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

“…Although the advantage of using cutting balloons instead of standard balloons remains to be demonstrated (30,31), the use of cutting balloons has shown interesting results, at least in difficult stenoses such as graft-to-vein anastomotic stenoses (31). A small series of eight patients also suggested that cutting balloons could be effective in treating stenoses that were resistant to the use of highpressure balloons (32). However, whether a more systematic use of cutting balloons in stenoses resistant to angioplasty would have improved our results remains to be proven.…”

Cutting balloons for the treatment of vascular stenoses

“…In haemodialysis fistulas rupture can occur even when an undersized CB is used, and the cephalic vein seems to be more sensitive to rupture with this device [56,66]. It seems that a critical point when one is treating stenoses associated with neointimal hyperplasia is to avoid CB dilatation to the same diameter immediately after failed standard balloon angioplasty, as the risk of vascular rupture increases significantly [67].…”

“…It seems that a critical point when one is treating stenoses associated with neointimal hyperplasia is to avoid CB dilatation to the same diameter immediately after failed standard balloon angioplasty, as the risk of vascular rupture increases significantly [67]. In a recent series of eight venous stenoses resistant to high-pressure balloon PTA in patients with failing Brescia-Cimino fistulas, although larger (5-8 mm) cutting balloons expanded completely in all stenoses, two focal ruptures of veins resulted in a 25% complication rate [66]. Leakage of the CB with no clinical sequelae has also been reported [56].…”

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

“…This is relevant because of the higher cost and technical limitations of cutting balloons such as balloon length/diameter, incompatibility with a 0.035-inch platform and difficulties dilating along tight curves. However, it may be appropriate to consider using cutting balloons for select, highly resistant stenosis as demonstrated by previous studies 3,7,8 and discussed by Vorwerk. 11…”

“…'s study cohort was composed of a subset of patients (15%) in whom conventional balloon angioplasty had failed . Previous studies have demonstrated that these resistant stenoses make up between 8% and 13% of stenotic lesions and respond favourably to cutting balloon angioplasty . Thus, inclusion of only resistant stenoses may limit the generalizability of this study to the majority of stenotic lesions, which are not resistant to conventional angioplasty.…”