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Abstract: PO1028

Real-World Efficacy of Paclitaxel-Coated Balloons (P-DCB) in the Treatment of Initial and Recurrent Arteriovenous Fistula (AVF) Stenosis

Session Information

Category: Dialysis

  • 703 Dialysis: Vascular Access

Authors

  • Fernandes Almeida, Richard S., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Cho, Min S., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Oo, Pye, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Karim, Muhammad Sohaib, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Pun, Conrad D., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Chan, Micah R., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Astor, Brad C., University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Gardezi, Ali I., University of Wisconsin-Madison, Madison, Wisconsin, United States
Background

A 2-year randomized trial has shown variable efficacy of P-DCB in AVF angioplasty when compared to non coated balloons (NCB). A subsequent study at our center showed the average time to lesion recurrence after P-DCB AVF angioplasty to be significantly shorter than NCB. Selection bias of using P-DCB more often in frequently recurring lesions was attributed to this observation. Our study was conducted to evaluate if use of P-DCB has better outcomes in initial lesions.

Methods

We retrospectively reviewed charts of 277 AVF balloon angioplasties performed over a 19 month period (July 2018 through January 2020). Patients were stratified into 4 groups: P-DCB initial lesions (n=26), NCB initial lesions (n=95), P-DCB recurrent lesions (n=46), NCB recurrent lesions (n=110). Patients were followed until recurrence or until January 2021 for lesions that did not recur.

Results

Groups were similar in terms of baseline characteristics. In the initial lesion group, 15 of 26 patients (57.69 %) treated with P-DCB and 64 of 95 patients (67.3 %) treated with NCB had recurrence during the follow up period of 1 year. There was a trend toward less recurrence in the P-DCB group but it did not reach statistical significance. (p=0.358). In the recurrent lesion group, 34 of 46 patients (73.9 %) treated with P-DCB and 71 of 110 patients (64.5 %) treated with NCB had recurrence during follow up. The difference was not statistically significant. (p=0.255).

Conclusion

There is no significant difference in recurrence rates for initial or recurrent lesions between the 2 balloons. However, there is a trend towards lower recurrence rates with P-DCB in initial lesions. There may be more benefit in treating initial lesions with P-DCB compared to recurrent lesions but further studies with larger number of patients are needed to substantiate these findings.