Angioplasty for dysfunctional arteriovenous fistulas: A meta-analysis of recent randomized controlled trials compared paclitaxel-coated balloon versus conventional balloon angioplasty

作者全名："Yang, Qin; Xia, Congying"

作者地址："[Yang, Qin] Southwest Jiaotong Univ, Peoples Hosp Chengdu 3, Dept Gen Surg, Sect Hepatobiliary Pancreat Surg,Affiliated Hosp, Chengdu, Peoples R China; [Yang, Qin] Chongqing Med Univ, Affiliated Hosp Chengdu 2, Chengdu, Peoples R China; [Xia, Congying] Sichuan Univ, West China Hosp, Dept Cardiol, 37 Guoxue St, Chengdu 610041, Sichuan, Peoples R China"

通信作者："Xia, CY (通讯作者)，Sichuan Univ, West China Hosp, Dept Cardiol, 37 Guoxue St, Chengdu 610041, Sichuan, Peoples R China."

来源：JOURNAL OF VASCULAR ACCESS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001114220300001

JCR分区：Q3

影响因子：1.6

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Arteriovenous fistula; drug-coated balloon; systematic review; meta-analysis; hemodialysis vascular access

摘要："Background: Stenosis in arteriovenous fistulas (AVF) due to neointimal hyperplasia is one of the most common causes of hemodialysis vascular access dysfunction. Treating patients with dysfunctional AVF with drug-coated balloon (DCB) angioplasty may potentially improve outcomes. Objectives: This systematic review aimed to compare the effectiveness and safety of DCB angioplasty versus conventional balloon angioplasty by pooling evidence from the most recent randomized controlled trials. Methods: We conducted a comprehensive literature search in the Web of Science, Embase, and Cochrane central databases. Two independent researchers screened the article, extracted interest, and evaluated included studies for risk of bias. Pooled estimation was conducted in terms of 6-month target-lesion primary patency (TLPP) and target-lesion reintervention (TLR), as well as other outcomes. Results: Results were expressed with odds ratio (OR) and 95% confidence interval (CI). A total of five RCTs were identified and included in the meta-analyses, with 1107 participants. DCB has a trend of a higher rate of TLPP (OR 1.79, 95% CI 0.66-4.90, p = 0.181) and a significantly lower rate of TLR (0.52, 95% CI 0.29-0.92, p = 0.034), as compared to conventional balloon angioplasty. No difference in the 6-month access circuit primary patency and reinvention was observed between the two groups. Conclusion: DCB may be an alternative treatment of dysfunctional AVF given a trend of a higher rate of TLPP and a significantly lower rate of TLR than conventional balloon angioplasty within 6 months after the indexed procedure. Moreover, DCB was non-inferior to conventional balloon angioplasty in terms of safety. Considering variations in the DCB technique, further studies are warranted for a standardized process."

基金机构："Sichuan Science and Technology Program; Department of Medical Affairs, Cardionovum Co, Ltd"

基金资助正文："We thank Dr. Yufang Chen, from the Department of Medical Affairs, Cardionovum Co, Ltd, for her contribution to data collection and consultation."