Local delivery of heparin with balloon angioplasty: results of a prospective randomized trial.
OBJECTIVE
To evaluate the effectiveness of local delivery of heparin via hydrogel-coated balloons in the treatment of vascular stenoses associated with hemodialysis access.


METHODS
This was a randomized, prospective trial comparing treatment with hydrogel-coated balloon catheters delivered with heparin coating (n = 33) and without (n = 26). All patients were undergoing hemodialysis, and all stenoses involved the venous anastomosis of a dialysis graft or a native vein. The heparin-treated balloons were soaked in concentrated heparin and delivered in a protected manner to help prevent washout of heparin.


RESULTS
The mean primary patencies were 143 days with heparin treatment and 214 days without heparin (P = .174). The mean assisted primary patencies were 165 days with heparin and 194 days without (P = .315). The mean secondary patencies were 351 days with heparin and 384 without (P = .81).


CONCLUSIONS
In this population with this technique, the treatment outcome of venous outflow stenosis in patients with dialysis grafts is not improved with local delivery of heparin.
Sheley
R C
RC
Department of Radiology, Legacy Good Samaritan Hospital and Medical Center, Portland, OR 97210, USA.
Schuman
E S
ES
Standage
B A
BA
Ragsdale
J W
JW
Feliciano
P D
PD
Quinn
S F
SF
D000800:Angioplasty, Balloon; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D001166:Arteriovenous Shunt, Surgical; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy*; D006493:Heparin / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D014654:Vascular Patency
D000925:Anticoagulants; D011138:Polytetrafluoroethylene; D006493:Heparin