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Kidney Week

Abstract: TH-PO342

Drug Eluting Balloon Angioplasty in Dialysis Access

Session Information

  • Vascular Access - I
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Spanuchart, Ittikorn, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Abreo, Kenneth D., Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Sequeira, Adrian P., Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Amin, Bakhtiar, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Buffington, Mary A., Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Abreo, Adrian P., Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
  • Sachdeva, Bharat, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
Background

Recurrent stenosis is responsible for less than 50 percent patency at 6 months. Neo-intimal hyperplasia (NIH) is driven by hemodynamic factors and barotrauma from angioplasty. Paclitaxel has been shown to reduce NIH. In a RCT, paclitaxel-coated balloon (Lutonix®) angioplasty compared to conventional angioplasty in AVFs showed better target lesion primary patency (TLPP) at 24 months. We present our data using Lutonix® in the treatment of recurrent stenosis in dialysis accesses.

Methods

This is a retrospective review of all angioplasties from June 1, 2017 to December 31, 2018 done at our hospital. A total of ten patients who underwent Lutnonix® angioplasties after successful conventional balloon angioplasties (< 30% residual stenosis) were included in the study. The target lesion angioplasty free periods before and following Lutnonix® angioplasty were reviewed. Re-interventions requiring angioplasty were clinically driven.

Results

Technical success of target lesion angioplasty was 100% for all angioplasties. The Lutonix® application following conventional angioplasty had a twice longer angioplasty free period compared to conventional angioplasty alone (mean of 320 versus 166 days, respectively) which represents a difference of 154 days, p = 0.04, 95% CI (11, 297). The 6-month TLPP (the index lesion) following Lutonix® angioplasty was 80%. No complications were reported with its use.

Conclusion

Lutonix® application following successful conventional angioplasty appears effective in delaying dialysis access clinically-driven re-stenosis requiring angioplasty. Further longer term studies are required to confirm the effectiveness of the Lutonix® angioplasty and see it is a suitable alternative for stent placement.