Comparison of Functional Patency Rates Between Paclitaxel-eluting versus Plain Balloon Angioplasty in Hemodialysis Patients with Central Venous Stenosis: An Intra-individual Comparison Study.

PURPOSE: Central venous stenosis (CVS) is usually a late-diagnosed clinical entity that is common in hemodialysis patients. It causes various problems ranging from hemodialysis difficulty to loss of the arterio-venous (A-V) fistula. In the present study, we aimed to determine the effect of drug eluting balloon while excluding the influence of other variable factors by evaluating the same individuals with plain and paclitaxel-eluting balloons.

METHODS: This research was a prospective study of 18 symptomatic hemodialysis patients (age 50.9±14.0 years, range 32-72 years; 11 male, 7 female) with CVS who underwent treatment by plain balloon angioplasty (PBA) and paclitaxel-coated balloon angioplasty (PEBA) in our hospital from January 2016 to June 2017. First, third and sixth month central vein patency rates were compared.

RESULTS: The median patency rates of central veins were 109.0 (range: 10-324) days after PBA and 238.5 (range: 157-501) days after PEBA (p< 0.001). There was no statistically significant difference between PBA and PEBA angioplasty in one-month patency (p˃0,05). By contrast, a statistically significant difference was found between three- and six-month patency rates (p = 0.031 and p ˂ 0.001, respectively). Kaplan-Meier analysis revealed that the primary cumulative patency rate of PEBA was significantly longer than that of PBA (p ˂ 0.001).

CONCLUSION: In thıs prospective study, PEBA patency is superior to PBA patency in the treatment of CVS in dialysis patients. This article is protected by copyright. All rights reserved.