Usefulness of paclitaxel-releasing high-pressure balloon associated with cutting balloon angioplasty for treatment of outflow stenoses of failing hemodialysis arteriovenous shunts.
OBJECTIVE
To evaluate the technical and clinical success, primary patency (PP) and complications of angioplasty performed with paclitaxel-coated balloon (PCBs) associated with cutting balloon and for the treatment of the outflow stenoses of failing hemodialysis arteriovenous shunt.


METHODS
From September 2014 to September 2015, 50 patients with 66 stenoses were registered. Vascular accesses were autogenous (n = 20) and prosthetic (n = 30). Stenosis were documented during follow-up with routine echo-color Doppler, clinical evaluation and in the remaining incidentally during fistulography. Angioplasty was performed with cutting balloon and afterward with PCB. The mean follow-up time was 8 months (range 6-15 months). Technical success, clinical success, primary patency and complications were registered.


RESULTS
Technical success was 100 %. Clinical success was 94.7 %. Primary patency rate was 87.7 %; in five patients, a significant re-stenosis (≥50 %) was registered. A residual asymptomatic stenosis (<30 %) was registered in four cases (7 %). No major complications were registered.


CONCLUSIONS
A short-term patency benefit may be obtained including PCB in angioplasty treatment of failing hemodialysis arteriovenous shunts.
Interventional Radiology, Department of Radiology, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Anna Maria
AM
Ierardi
Vascular Surgery Department, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Marco
M
Franchin
Interventional Radiology, Department of Radiology, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Federico
F
Fontana
Vascular Surgery Department, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Gabriele
G
Piffaretti
Interventional Radiology, Department of Radiology, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Ejona
E
Duka
Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan (MI), Italy.
Massimo
M
Tonolini
Department of Emergency Radiology, S. Camillo Hospital, Circonvallazione Gianicolense, 87, 00152, Rome, Italy.
Vittorio
V
Miele
Vascular Surgery Department, University of Insubria, Viale L. Borri, 57, 21100, Varese (VA), Italy.
Matteo
M
Tozzi
Diagnostic and Interventional Radiology Unit, Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy. gcarraf@gmail.com.
Gianpaolo
G
Carrafiello
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D006435:Renal Dialysis; D016896:Treatment Outcome; D014654:Vascular Patency
D017239:Paclitaxel
Hemodialysis arteriovenous shunt; Outflow stenoses; Paclitaxel-coated balloon