2017 Volume 50 Issue 1 Pages 81-86
The stenosis of arteriovenous fistulas (AVF) or arteriovenous grafts (AVG) in chronic hemodialysis patients is often treated with balloon-assisted percutaneous transluminal angioplasty (PTA), but short-term recurrent restenosis remains a problem. We treated recurrent restenosis in 6 vascular access vessel lesions in 5 patients using drug (paclitaxel) -coated balloons (DCB, SeQuent Please balloon). Four of the target lesions were located in AVF, one was located in an AVG, and the remaining lesion involved stent restenosis of the subclavian vein. All lesions were pre-dilated using a 3- or 4-mm-diameter balloon, and paclitaxel was delivered via a 3.5- or 4.0-mm-diameter DCB, which was inflated for 120 sec. Two lesions required re-PTA after 7 and 16 months, but the culprit lesions were not located at the DCB-treated sites; rather, they were new stenotic lesions. No flow disturbance was seen in the other 4 lesions. In comparison with their pre-DCB values, the patency periods of the treated vascular access vessels were significantly longer after the DCB treatment (pre-DCB vs. post-DCB: 3.4±1.9 vs. 10.8±5.9 months, p<0.0001). DCB angioplasty was very effective at maintaining good vascular access flow in recurrent restenotic lesions.
