Drug-coated balloon angioplasty for failing arteriovenous fistulae: feasibility and short-term outcomes

Aim
To evaluate the feasibility, efficacy, and short-term and mid-term outcomes of drug-coated balloons (DCBs) in salvage of failing dialysis access owing to significant access vein stenosis.
Patients and methods
DCB angioplasty was used for salvage of failing arteriovenous fistulae in patients with clinical and radiological evidences of recently (within 14 days) failing hemodialysis access between March 2019 and September 2019.
Results
A total of 23 patients were enrolled, comprising 15 males and eight females, with mean age of 52.9±15.3 years. All lesions were successfully crossed and predilated with plain old balloons sized to the available normal vein diameter before DCB angioplasty, except in one patient with central vein tight stenosis. Technical success was achieved in 21 of 23 patients. At 1 month after angioplasty, among 21 successful angioplasty patients, one patient had died of cause not related to the procedure. For the remaining 20 patients, 17 patients still had a patent access, representing 80.9% success rate; two patients could not show any clinical improvement for their access although remaining patent; and one patient showed early access thrombosis about 1 weak after angioplasty. In the 6-month follow-up, of the remaining 17 patients with successful angioplasty, one patient had died owing to causes not related to the procedure. In the remaining 16 patients, 15 patients still had a patent vascular access with one patient lost to follow-up, thus representing an overall success rate of 71.4%.
Conclusion
DCB angioplasty is a safe and effective method for salvage of the failing arteriovenous fistulae and could successfully delay recurrence of stenosis.