Cutting Balloon angioplasty for the treatment of haemodyalisis vascular accesses: midterm results.
OBJECTIVE
The purpose of this study was to assess the effectiveness of Cutting Balloon angioplasty in the treatment of stenoses in haemodialysis arteriovenous accesses.


METHODS
Over the past 2 years, we have observed 80 patients with stenotic haemodialysis accesses; 24 of these (mean age 66.4 years, range 50-81) with 26 stenoses of 24 accesses (21 Cimino-Brescia fistulas and 3 dialysis loops) were selected for Cutting Balloon angioplasty. In 11 cases, the Cutting Balloon device was used after failure to dilate the access with a high-pressure balloon whereas in 15 cases (10 focal stenoses and 5 restenoses), it was used as a first choice. Two Cutting Balloon devices had a diameter of 8 mm, two of 7 mm, 11 of 6 mm, eight of 5 mm and one of 4 mm. The follow-up was performed by colour Doppler ultrasound (CDUS) and clinical assessment at 1, 3, 6, 12, 18 and 24 months.


RESULTS
In all patients, postprocedure angiography demonstrated immediate technical success. No periprocedural complications occurred. Follow-up examinations (range 3-24 months, mean 18.2 months) demonstrated patency of the vascular access and its good functioning during dialysis in 23/24 cases (95%). Only in one case did we observe a haemodynamically significant restenosis, which was treated again with Cutting Balloon angioplasty.


CONCLUSIONS
Cutting Balloon angioplasty is safe and effective in the treatment of haemodialysis access stenosis, especially in cases of severe stenosis, with low restenosis rate both in the short and medium term.
Carrafiello
G
G
Radiologia Vascolare e Interventistica, Cattedra di Radiologia, Varese, Italy. gcarraf@tin.it
Laganà
D
D
Mangini
M
M
Recaldini
C
C
Mancassola
G
G
Frattini
G
G
Colussi
G
G
Dionigi
G
G
Fugazzola
C
C
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003287:Contrast Media; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D015641:Radiography, Interventional; D006435:Renal Dialysis; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
D003287:Contrast Media