Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty

Abstract Background Treatment of cephalic arch stenosis (CAS) with standard plain old balloon angioplasty (POBA) in dysfunctional arteriovenous fistulas (AVF), is associated with early re-stenosis and higher failure rates compared to other lesions. Paclitaxel-coated balloons (PCB) may improve patenc...

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Autores principales:	Ren Kwang A. Tng, Ru Yu. Tan, Shereen X. Y. Soon, Suh Chien. Pang, Chieh Suai. Tan, Charyl J. Q. Yap, Apoorva. Gogna, Tze Tec. Chong, Tjun Y. Tang
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Cephalic arch stenosis Paclitaxel Angioplasty Arteriovenous fistula Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/bb365d1fcc2841abbad974060110c30a
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spelling	oai:doaj.org-article:bb365d1fcc2841abbad974060110c30a2021-12-05T12:25:54ZTreatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty10.1186/s42155-021-00271-12520-8934https://doaj.org/article/bb365d1fcc2841abbad974060110c30a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s42155-021-00271-1https://doaj.org/toc/2520-8934Abstract Background Treatment of cephalic arch stenosis (CAS) with standard plain old balloon angioplasty (POBA) in dysfunctional arteriovenous fistulas (AVF), is associated with early re-stenosis and higher failure rates compared to other lesions. Paclitaxel-coated balloons (PCB) may improve patency rates. This is a retrospective cohort study. Patients who underwent POBA or PCB for CAS over a 3-year period were included. Outcomes compared were circuit primary patency rates (patency from index procedure to next intervention), circuit primary assisted-patency rates (patency from index procedure to thrombosis), and target lesion (CAS) patency rates (stenosis > 50%) at 3, 6 and 12 months. Results Ninety-one patients were included. Sixty-five (71.4%) had POBA, while 26 (28.6%) had PCB angioplasty. There were 62 (68.1%) de-novo lesions. CAS was the only lesion that needed treatment in 24 (26.4%) patients. Circuit primary patency rates for POBA versus PCB groups were 76.2% vs. 60% (p = 0.21), 43.5% vs. 36% (p = 0.69) and 22% vs. 9.1% (p = 0.22) at 3, 6 and 12-months respectively. Circuit assisted-primary patency rates were 93.7% vs. 92% (p = 1.00), 87.1% vs. 80% (p = 0.51) and 76.3% vs. 81.8% (p = 0.77), whilst CAS target lesion intervention-free patency rates were 79.4% vs. 68% (p = 0.40), 51.6% vs. 52% (p = 1.00) and 33.9% vs. 22.7% (p = 0.49) at 3, 6 and 12-months respectively. Estimated mean time to target lesion intervention was 215 ± 183.2 days for POBA and 225 ± 186.6 days for PCB (p = 0.20). Conclusion Treatment of CAS with PCB did not improve target lesion or circuit patency rates compared to POBA.Ren Kwang A. TngRu Yu. TanShereen X. Y. SoonSuh Chien. PangChieh Suai. TanCharyl J. Q. YapApoorva. GognaTze Tec. ChongTjun Y. TangSpringerOpenarticleCephalic arch stenosisPaclitaxelAngioplastyArteriovenous fistulaDiseases of the circulatory (Cardiovascular) systemRC666-701ENCVIR Endovascular, Vol 4, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cephalic arch stenosis Paclitaxel Angioplasty Arteriovenous fistula Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Cephalic arch stenosis Paclitaxel Angioplasty Arteriovenous fistula Diseases of the circulatory (Cardiovascular) system RC666-701 Ren Kwang A. Tng Ru Yu. Tan Shereen X. Y. Soon Suh Chien. Pang Chieh Suai. Tan Charyl J. Q. Yap Apoorva. Gogna Tze Tec. Chong Tjun Y. Tang Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
description	Abstract Background Treatment of cephalic arch stenosis (CAS) with standard plain old balloon angioplasty (POBA) in dysfunctional arteriovenous fistulas (AVF), is associated with early re-stenosis and higher failure rates compared to other lesions. Paclitaxel-coated balloons (PCB) may improve patency rates. This is a retrospective cohort study. Patients who underwent POBA or PCB for CAS over a 3-year period were included. Outcomes compared were circuit primary patency rates (patency from index procedure to next intervention), circuit primary assisted-patency rates (patency from index procedure to thrombosis), and target lesion (CAS) patency rates (stenosis > 50%) at 3, 6 and 12 months. Results Ninety-one patients were included. Sixty-five (71.4%) had POBA, while 26 (28.6%) had PCB angioplasty. There were 62 (68.1%) de-novo lesions. CAS was the only lesion that needed treatment in 24 (26.4%) patients. Circuit primary patency rates for POBA versus PCB groups were 76.2% vs. 60% (p = 0.21), 43.5% vs. 36% (p = 0.69) and 22% vs. 9.1% (p = 0.22) at 3, 6 and 12-months respectively. Circuit assisted-primary patency rates were 93.7% vs. 92% (p = 1.00), 87.1% vs. 80% (p = 0.51) and 76.3% vs. 81.8% (p = 0.77), whilst CAS target lesion intervention-free patency rates were 79.4% vs. 68% (p = 0.40), 51.6% vs. 52% (p = 1.00) and 33.9% vs. 22.7% (p = 0.49) at 3, 6 and 12-months respectively. Estimated mean time to target lesion intervention was 215 ± 183.2 days for POBA and 225 ± 186.6 days for PCB (p = 0.20). Conclusion Treatment of CAS with PCB did not improve target lesion or circuit patency rates compared to POBA.
format	article
author	Ren Kwang A. Tng Ru Yu. Tan Shereen X. Y. Soon Suh Chien. Pang Chieh Suai. Tan Charyl J. Q. Yap Apoorva. Gogna Tze Tec. Chong Tjun Y. Tang
author_facet	Ren Kwang A. Tng Ru Yu. Tan Shereen X. Y. Soon Suh Chien. Pang Chieh Suai. Tan Charyl J. Q. Yap Apoorva. Gogna Tze Tec. Chong Tjun Y. Tang
author_sort	Ren Kwang A. Tng
title	Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
title_short	Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
title_full	Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
title_fullStr	Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
title_full_unstemmed	Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
title_sort	treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/bb365d1fcc2841abbad974060110c30a
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Treatment of cephalic arch stenosis in dysfunctional arteriovenous fistulas with paclitaxel-coated versus conventional balloon angioplasty

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