Primary patency rate with paclitaxel-coated balloon angioplasty versus covered stenting of failed arteriovenous grafts: a retrospective comparative study

Aim
To compare the technical success, primary patency of thrombosed prosthetic vascular access grafts of the upper limb after thrombectomy and to deal with the stenosis at the venous anastomotic site either with percutaneous angioplasty with a paclitaxel-coated balloon or with stenting using a covered stent.
Patients and methods
We reviewed the data of 47 patients with thrombosed prosthetic vascular access polytetrafleuroethylene grafts of the upper limb, who met our inclusion criteria, from January 2014 till January 2021. The patients underwent thrombectomy and intraoperative angiography. The patients were stratified into two groups according to how we dealt with the venous anastomotic site. In group A, we used a paclitaxel-coated balloon, whereas in group B, we used a covered stent.
Results
The success rate was 100% (=26), 100% (=21) in both groups, in either the technical aspect or the clinical one (having dialysis from the access). There was no statistically significant difference between both groups regarding descriptive data. Moreover, there was no statistically significant difference between both groups regarding the time since creation of the access (=0.9159). The primary patency rates of the procedure for group A at 3, 6, 12, 18, and 24 months were 88.46, 73.08, 61.54, 53.85, and 42.31%, respectively, whereas in group B, they were 90.48, 80.95, 66.67, 57.14, and 52.38%, respectively.
Conclusion
The use of covered stent has a higher patency rate than using paclitaxel-coated percutaneous angioplasty balloon catheters for treating venous site anastomotic stenosis, especially in the mid-term follow-up periods, but still these results are statistically insignificant, may be owing to the small number of the study sample.