Paclitaxel-Coated Balloon Angioplasty for Early Restenosis of Central Veins in Hemodialysis Patients: A Single Center Initial Experience.
10.3348/kjr.2018.19.3.410
- Author:
Keerati HONGSAKUL
1
;
Kittipitch BANNANGKOON
;
Sorracha ROOKKAPAN
;
Ussanee BOONSRIRAT
;
Boonprasit KRITPRACHA
Author Information
1. Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand. hkeerati@medicine.psu.ac.th
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Paclitaxel-coated balloon;
Patency;
Angioplasty;
Stenosis;
Central vein
- MeSH:
Angioplasty;
Angioplasty, Balloon*;
Constriction, Pathologic;
Female;
Humans;
Male;
Renal Dialysis*;
Veins*
- From:Korean Journal of Radiology
2018;19(3):410-416
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To report the results of angioplasty with paclitaxel-coated balloons for the treatment of early restenosis of central veins in hemodialysis patients. MATERIALS AND METHODS: Sixteen patients (9 men and 7 women; mean age 65.8 ± 14.4 years; range, 40–82 years) with 16 episodes of early restenoses of central veins within 3 months (median patency duration 2.5 months) were enrolled from January 2014 to June 2015. Ten native central veins and 6 intra-stent central veins were treated with double paclitaxel-coated balloons (diameter 6–7 mm) plus a high pressure balloon (diameter 12–14 mm). The study outcomes included procedural success (< 30% residual stenosis) and primary patency of the treated lesion (< 50% angiographic stenosis without re-intervention). RESULTS: Procedural success was achieved in all 16 cases of central vein stenoses. The mean diameter of the central vein was 3.7 ± 2.4 mm before the procedure vs. 11.4 ± 1.8 mm after the initial procedure. There were no procedure-related complications. The mean diameters of the central veins at 6 months and 12 months were 7.8 ± 1.3 mm and 6.9 ± 2.7 mm, respectively. The primary patency rates at 6 months and 12 months were 93.8% and 31.2%, respectively. One patient had significant restenosis of the central vein at 3 months. The median primary patency period was 9 months for paclitaxel-coated balloons and 2.5 months for the last previous procedure with conventional balloons (p < 0.001). CONCLUSION: In our limited study, paclitaxel-coated balloons seem to improve the patency rate in cases of early restenosis of central veins. However, a further randomized control trial is necessary.