Comparison of drug-coated balloon versus plain balloon angioplasty for autogenous hemodialysis access dysfunction: A prospective cohort study | ||
| The Egyptian Journal of Surgery | ||
| Volume 43, Issue 4, October 2024, Pages 1587-1596 PDF (679.33 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2024.303935.1119 | ||
| Authors | ||
| Mohamed I. Mohamed1; Ahmed A. Eldeeb* 2; Ayman A.M. Hassan1; Mina G.Z. Basta3 | ||
| 1Department of Vascular Surgery, Faculty of Medicine, Ain Shams University, Cairo, eGYPT | ||
| 2Department General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt | ||
| 3Department of aVascular Surgery, Faculty of Medicine, Ain Shams University, Cairo, eGYPT | ||
| Abstract | ||
| Background: Both drug-coated balloon (DCB) angioplasty and conventional plain balloon angioplasty can be implemented to treat hemodialysis dysfunction. The present study aims to compare the safety and efficacy of these two approaches by conducting a prospective cohort study. Objective: The study aims to evaluate DCB safety and arteriovenous fistula effectiveness in relation to plain balloon for hemodialysis access dysfunction. Patients and Methods: All patients were allocated and blinded, randomized during the period of study into two groups. Group A: patients were operated on with drug-eluting balloons (n=40), while group B patients were operated on with standard balloons (n=40). The results of both groups were analyzed and compared. Results: DCB was used to treat 40 patients (mean age, 49.48±8 years) with failed arteriovenous fistulas. These patients were compared with a reference group of 40 patients, mean age 50.6±9.4 years, who had just simple balloon PTA. Regular PTA balloons were used to dilate every case of stenosis. In the research group, DCBs were used for medication delivery after hemodynamic success (30% residual stenosis). The 6-, 12-, and 24-month follow-up intervals were used. Comparisons were made between primary, primary assisted, and secondary patency. At 0.05, the statistical significance was established. When primary patency was evaluated between the two groups, it was shown that the study group (DCB) had substantially greater results at 12 months (75.0 vs. 52.5%; P=0.036) and 24 months (52.5 vs. 30.0%; P=0.041). At 24 months, there were notable variations in secondary patency (52.5 vs. 30.0; P=0.041). Conclusion: In addition to lowering the number of interventions and improving target lesion primary patency over the first 12 and 24 months, DCB also improves secondary patency at the 24-month mark. | ||
| Keywords | ||
| Arteriovenous fistula; drug-coated balloon angioplasty; hemodialysis dysfunction; plain balloon angioplasty | ||
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