Patency of arteriovenous haemodialysis fistulas: drug-eluting versus plain balloon angioplasty
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Purpose: To assess the patencies of radiocephalic arteriovenous (AV) haemodialysis fistulas following drug-eluting balloon (DEB) angioplasty compared with plain balloon (PB) angioplasty. Methods: This retrospective case-control study comprised 26 patients who had undergone at least one PB angioplasty and a re-operation (index operation) with either PB or DEB angioplasty (13 DEB and 13 PB). Two separate analyses were conducted to investigate the effect of the DEB. First, the stenosis-free periods after the index operation were assessed and compared between the DEB and PB groups. Second, a case-crossover study was performed in which the stenosis-free period after DEB was compared with the stenosis-free period after the previous operation within the DEB group only. The results were assessed using Kaplan-Meier survival analysis and generalized Wilcoxon statistical analysis. Results: Both analyses revealed significantly improved patency following DEB compared with PB angioplasty (p=0.028 for the DEB versus PB group analysis and p=0.013 for the case-crossover analysis). DEB treatment resulted in a 12-month cumulative survival of 65.8% in the intervention group (IG) versus 30.8% in the control group (CG), and within the IG group, the corresponding values were 65.8% and 15.4%. Conclusions: Drug-eluting balloon angioplasty significantly improves the patencies of radiocephalic AV fistulas compared with plain balloon angioplasty.