The findings of optical coherence tomography before and after percutaneous transluminal angioplasty for vascular access restenosis lesions

Abstract

Percutaneous transluminal angioplasty (PTA) for blood flow disturbances in arteriovenous fistulas has become a widely accepted technique and has been recommended as the first-line treatment for maintaining vascular access (VA), but the increased restenosis rate seen after balloon angioplasty remains a problem. Target lesion restenosis after PTA is mainly caused by neointimal proliferation associated with the repair of the injured intima and media. We studied optical coherence tomography (OCT) images obtained before and after PTA for restenosis lesions using non-compliant balloons, semi-compliant balloons, and scoring balloons, such as the Cutting balloon, NSE balloon, and AngioSculpt balloon. The OCT images showed large dissection lesions and a lot of intimal damage after PTA was performed using non-compliant or semi-compliant balloon, which are inflated rapidly. However, less intimal damage was caused by the non-compliant balloon, Cutting balloon, NSE balloon, and AngioSculpt balloon, which are inflated slowly at a minimal inflation pressure. The findings of OCT are useful for evaluating intimal damage after PTA for restenotic VA lesions.