Comparison between the 0- and 30-s balloon dilation time in percutaneous transluminal angioplasty for restenosed arteriovenous fistula among hemodialysis patients: a multicenter, prospective, randomized trial (CARP study).

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Clinical and Experimental Nephrology Pub Date : 2024-07-01 Epub Date: 2024-02-28 DOI:10.1007/s10157-024-02469-8
Tomoki Saiki, Kensuke Sasaki, Shigehiro Doi, Akira Takahashi, Yosuke Osaki, Naoki Ishiuchi, Yujiro Maeoka, Toru Kawai, Koichiro Kawaoka, Shunsuke Takahashi, Takuo Nagai, Taisuke Irifuku, Ayumu Nakashima, Takao Masaki
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引用次数: 0

Abstract

Background: This study aims to compare patency rates of the 0- and 30-s (sec) balloon dilation time in hemodialysis (HD) patients with restenosis after percutaneous transluminal angioplasty (PTA).

Methods: The patients who underwent PTA within 6 months for failed arteriovenous fistula at the forearm were randomly assigned the 0-s or 30-s dilation time group. Effect of dilation time on the 3- and 6-month patency rates after PTA was examined.

Results: Fifty patients were enrolled in this study. The 3-month patency rate in the 30-s dilation group was better than that in the 0-s dilation group (P = 0.0050), while the 6-month patency rates did not show a significant difference between the two groups (P = 0.28). Cox's proportional hazard model revealed that 30-s of inflation time (hazard ratio 0.027; P = 0.0072), diameter of the proximal (hazard ratio 0.32; P = 0.031), and dilation pressure (hazard ratio 0.63; P = 0.014) were associated with better 3-month patency. Dilation pressure between previous and present PTA did not differ in the 0-s (P = 0.15) and 30-s dilation groups (P = 0.16). The 6-month patency rate of the present PTA in the 30-s dilation group was higher than that of the previous PTA (P = 0.015). The visual analog scale did not differ between the two groups (P = 0.51).

Conclusion: The presenting data suggest that 30-s dilation potentially results in a better 3-month patency rate than 0-s dilation in HD patients with restenosis after PTA.

Abstract Image

经皮腔内血管成形术治疗血液透析患者再狭窄动静脉瘘的 0 秒和 30 秒球囊扩张时间比较:一项多中心、前瞻性、随机试验(CARP 研究)。
背景:本研究旨在比较经皮腔内血管成形术(PTA)后再狭窄的血液透析(HD)患者0秒和30秒球囊扩张时间的通畅率:因前臂动静脉瘘治疗失败而在6个月内接受PTA治疗的患者被随机分配到0秒或30秒扩张时间组。结果:50 名患者接受了 PTA:结果:50 名患者参与了这项研究。30 秒扩张组的 3 个月通畅率优于 0 秒扩张组(P = 0.0050),而 6 个月通畅率在两组间无显著差异(P = 0.28)。Cox 比例危险模型显示,30 秒充气时间(危险比为 0.027;P = 0.0072)、近端直径(危险比为 0.32;P = 0.031)和扩张压力(危险比为 0.63;P = 0.014)与 3 个月通畅率相关。在 0 秒扩张组(P = 0.15)和 30 秒扩张组(P = 0.16)中,前一次和本次 PTA 的扩张压力没有差异。30 秒扩张组中本次 PTA 的 6 个月通畅率高于前次 PTA(P = 0.015)。视觉模拟量表在两组之间没有差异(P = 0.51):本研究数据表明,对于 PTA 后出现再狭窄的 HD 患者,30 秒扩张术可能比 0 秒扩张术带来更好的 3 个月通畅率。
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来源期刊
Clinical and Experimental Nephrology
Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.10
自引率
4.30%
发文量
135
审稿时长
4-8 weeks
期刊介绍: Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.
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