Editor's Choice – Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials

Han, Ahram; Park, Taejin; Kim, Hyun Jung; Min, Seok-Ki; Ha, Jong‐Won; Min, Sang Il

doi:10.1016/j.ejvs.2021.05.043

Cited by 12 publications

(3 citation statements)

References 43 publications

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“…In contrast to this meta-analysis, previously reported studies concerning the EVT of other vascular diseases showed the benefit of DCBs in preventing the restenosis of target lesions compared to PBs [15][16][17][18]. Among them, AVF has similar aspects to vein grafts because both require venous adaptation to the arterial environment to achieve a long-term duration.…”

Section: Discussionmentioning

confidence: 62%

“…Several studies indicate that paclitaxel, a highly lipophilic antineoplastic drug, inhibits the proliferation of VSMC after administration to cell culture and swine tissues for a few minutes [14]. DCBs are valuable in many vascular diseases, including coronary artery disease [15], arteriovenous fistula (AVF) as blood access [16,17], and superficial femoral artery disease [18]. However, the superiority of DCB in the treatment of VGS after IAB remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

Isaji

Hosoi

Kogure

et al. 2022

JCM

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The optimal endovascular therapy for vein graft stenosis (VGS) following infrainguinal arterial bypass is yet to be established. Drug-coated balloons (DCB) have rapidly improved the inferior patency outcomes of angioplasty using a conventional plain balloon (PB). This study compares the efficacy of DCBs and PBs for the treatment of infrainguinal VGS. This systematic review and meta-analysis was performed according to the PRISMA statement. Multiple electronic searches were conducted in consultation with a health science librarian in September 2022. Studies describing the comparative outcomes of angioplasty using DCBs and PBs in the treatment of infrainguinal VGS were eligible. Datasets from one randomized controlled trial and two cohort studies with a total of 179 patients were identified. The results indicated no significant difference in target lesion revascularization between DCBs and PBs (OR, 0.64; 95% CI, 0.32–1.28; p = 0.21), with no significant heterogeneity between studies. Additionally, differences in primary patency, assisted primary patency, secondary patency, and graft occlusion were not significant. Subgroup analysis showed similar effects for different DCB devices. In conclusion, DCBs showed no significant benefit in the treatment of VGS compared to PBs. Given the small population size of this meta-analysis, future trials with a larger population are desired.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

Isaji

Hosoi

Kogure

et al. 2022

JCM

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“…Many other smaller RCTs (which included fewer than 40 arteriovenous accesses) have demonstrated contradictory results for both AVGs and AVFs. Arising from these studies are at least 14 meta-analyses (of 6-14 RCTs), most of which showed superiority of drug-eluting balloons compared with PTA at 6 and 12 months for target lesion primary patency in AVFs (72% vs 55% at 6 months), with no effect on mortality at 2 years . There were too few studies to evaluate the potential effect of drug-eluting balloons on AVG outcomes.…”

Section: Arteriovenous Access Complicationsmentioning

confidence: 99%

Arteriovenous Access for Hemodialysis

Lok,

Huber,

Orchanian-Cheff

et al. 2024

JAMA

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ImportanceHemodialysis requires reliable vascular access to the patient’s blood circulation, such as an arteriovenous access in the form of an autogenous arteriovenous fistula or nonautogenous arteriovenous graft. This Review addresses key issues associated with the construction and maintenance of hemodialysis arteriovenous access.ObservationsAll patients with kidney failure should have an individualized strategy (known as Patient Life-Plan, Access Needs, or PLAN) for kidney replacement therapy and dialysis access, including contingency plans for access failure. Patients should be referred for hemodialysis access when their estimated glomerular filtration rate progressively decreases to 15 to 20 mL/min, or when their peritoneal dialysis, kidney transplant, or current vascular access is failing. Patients with chronic kidney disease should limit or avoid vascular procedures that may complicate future arteriovenous access, such as antecubital venipuncture or peripheral insertion of central catheters. Autogenous arteriovenous fistulas require 3 to 6 months to mature, whereas standard arteriovenous grafts can be used 2 to 4 weeks after being established, and “early-cannulation” grafts can be used within 24 to 72 hours of creation. The prime pathologic lesion of flow-related complications of arteriovenous access is intimal hyperplasia within the arteriovenous access that can lead to stenosis, maturation failure (33%-62% at 6 months), or poor patency (60%-63% at 2 years) and suboptimal dialysis. Nonflow complications such as access-related hand ischemia (“steal syndrome”; 1%-8% of patients) and arteriovenous access infection require timely identification and treatment. An arteriovenous access at high risk of hemorrhaging is a surgical emergency.Conclusions and RelevanceThe selection, creation, and maintenance of arteriovenous access for hemodialysis vascular access is critical for patients with kidney failure. Generalist clinicians play an important role in protecting current and future arteriovenous access; identifying arteriovenous access complications such as infection, steal syndrome, and high-output cardiac failure; and making timely referrals to facilitate arteriovenous access creation and treatment of arteriovenous access complications.

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Vascular Access for Haemodialysis

Debus,

Grundmann

2023

Evidence-Based Therapy in Vascular Surgery

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Editor's Choice – Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials

Cited by 12 publications

References 43 publications

Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

Arteriovenous Access for Hemodialysis

Vascular Access for Haemodialysis

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