Endovascular therapy of arteriovenous fistulas for hemodialysis in an asian population

Abstract

versus plain balloon angioplasty (PBA) for the treatment of symptomatic central venous stenosis in dialysis access. Materials: Between January 2014 to August 2015, 40 dialysis patients with symptomatic central venous stenosis were randomized (1:1) to undergo either dilation with a 2μg/mm2 PCB (group PCB, n¼20) or PBA (group PBA, n¼20). Both de novo and restenotic [15/20; (75%) group PCB and 12/20; (60%) group PTA] lesions were treated. Primary endpoints were technical success and lesion primary patency (LPP). Secondary endpoints included complication rates and circuit primary patency. Individual subgroup longitudinal analysis was performed to compare outcomes of PCB versus previous treatment in the same patients for restenotic lesions in group PCB. Results: Until today, 6-month follow up is available in 14/20 (70%) cases in group PCB and in 18/20 (90%) cases in group PBA. According to Kaplan Meier analysis, LPP is 60% for group PCB and 45% for group PBA [p¼0.094; HR: 0.48 (95% CI: 0.201-1.13)]. Longitudinal analysis between treatments show a statistically significant difference in favor of PCB treatment compared to previous PBA [9/15 (60%) vs. 4/12 (33.3%); p¼0.001 HR: 4.39 (95%CI: 1.79-10.78]. Conclusions: Interim results of this prospective randomized trial show a trend to improved patency for PCB in the treatment of symptomatic central venous stenosis. Final results will be announced.