title: The Relationship Between Neutrophil-Lymphocyte Ratio and Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Arteriovenous Fistula Stenosis When Using Conventional and Drug-Eluting Balloons.
abstract: OBJECTIVE
  The aim of this study is to investigate the potential association of neutrophil-lymphocyte ratio (NLR) between primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula stenosis and type (Conventional and Drug-Eluting) of balloons used in PTA.
  
  
  METHODS
  This retrospective study consists of 78 patients with significant arteriovenous fistulas stenosis who were treated with PTA by using Drug-Eluting Balloon (DEB) (n = 29) or Conventional Balloon (CB) (n = 49). NLR was calculated from preinterventional blood samples. All patients were classified into two groups. Group A; primary patency <12 months (43/78), Group B; primary patency ≥12 months (35/78). Cox regression analysis and Kaplan-Meier method were used to determine respectively independent factors affecting the primary patency and to compare the primary patency for the two balloon types.
  
  
  RESULTS
  NLR ratio and balloon type of the two groups were significantly different (p = 0.002, p = 0.010). The cut-off value of NLR was 3.18 for determination of primary patency, with sensitivity of 81.4 % and specificity of 51.4 %. Primary patency rates between PTA with DEB and CB displayed statistically significant differences (p < 0.05). The cut-off value was 3.28 for determination of 12-month primary patency with the conventional balloon group; sensitivity was 81.8 % and specificity was 81.3 %. There was no statistical relation between NLR levels and the drug-eluting balloon group in 12-month primary patency (p = 0.927).
  
  
  CONCLUSIONS
  Increased level of NLR may be a risk factor in the development of early AVF restenosis after successful PTA. Preferring Drug-Eluting Balloon at an increased level of NLR can be beneficial to prolong patency.
authors: Department of Diagnostic and Interventional Radiology, Adnan Menderes University, 09100, Aydın, Turkey. mbcildag@yahoo.com.
authors: Mehmet Burak
authors: MB
authors: Çildağ
authors: Department of Immunology and Allergy, Adnan Menderes University, 09100, Aydın, Turkey.
authors: Songül
authors: S
authors: Çildağ
authors: Department of Diagnostic and Interventional Radiology, Adnan Menderes University, 09100, Aydın, Turkey.
authors: Ömer Faruk Kutsi
authors: ÖF
authors: Köseoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D001164:Arteriovenous Fistula / Q000378:metabolism / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D006435:Renal Dialysis; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D055815:Young Adult
keywords: Arteriovenous fistula; Conventional balloon angioplasty; Drug-eluting balloon angioplasty; Neutrophil–Lymphocyte ratio; Primary patency; Restenosis