Results of a peripheral cutting balloon prospective multicenter European registry in hemodialysis vascular access

• Published in: Cardiovascular and interventional radiology 2007-04, Vol.30 (2), p.212-215
• Main Authors: Peregrin, Jan H, Rocek, Miloslav
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Angioplasty; Angioplasty, Balloon; Arteriovenous Shunt, Surgical - adverse effects; BYPASSES; CUTTING; Europe; Extremities - blood supply; Female; Follow-Up Studies; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - physiopathology; Graft Occlusion, Vascular - therapy; Humans; LIMBS; Male; Middle Aged; PAIN; Pain, Postoperative - etiology; POLYCHLORINATED BIPHENYLS; Prospective Studies; RADIOLOGY AND NUCLEAR MEDICINE; Registries; Renal Dialysis - adverse effects; Severity of Illness Index; Time Factors; Treatment Outcome; Vascular Patency; Vascular Resistance
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-006-0020-0

To report initial experience with the Peripheral Cutting Balloon (PCB) in treatment of failing hemodialysis shunts. A total of 190 patients (95 men, 95 women; average age 64.4 +/- 11.9 years, range 32-87 years) who were treated with the PCB for pressure-resistant stenosis, restenosis or failed percutaneous transluminal angioplasty (PTA) in the venous limb of an arteriovenous shunt were followed in seven European centers using a simple registry. The group consisted of 109 de novo lesions (57%) and 79 restenotic lesions (43%). Technical success was achieved in 88.9% of cases. Primary patency was as follows (the results for whole group and simultaneous results for de novo lesions and restenoses are presented): 1 month (140 patients followed): 94%, 98%, and 93%; 3 months (116 patients followed): 93%, 98%, and 92%; 6 months (40 patients followed): 85%, 92%, and 79%; 12 months (27 patients followed): 74%, 87%, and 48%. No complication occurred. Patients experienced an equal or lower level of pain during the procedure compared with conventional PTA. The PCB proved to be successful in dilating pressure-resistant stenoses. We cannot conclude whether PCB angioplasty can lower the restenosis rate in hemodialysis access lesions, but the long-term patency for de novo lesions is high. A further randomized study is advisable.