Efficacy of drug-coated balloon for repeated short-term restenosis of dialysis arteriovenous fistulas.

Background: Drug-coated balloons (DCB) are used for vascular access interventional therapy (VAIVT). However, few studies on patients with repeated short-term restenosis after VAIVT using a standard balloon (SB) have been reported, and the effect of DCB use on patency in these patients remains unclear.

Purpose: This study aimed to evaluate the efficacy of DCB in patients with repeated short-term restenosis after VAIVT with SB.

Materials and methods: This was a single-center retrospective study. We enrolled 50 consecutive patients who suffered two consecutive restenosis episodes within 6 months after VAIVT with SB. In the third session, patients were treated with DCB or SB. Target lesion revascularization (TLR) was evaluated for 1 year after the third session, with the primary endpoint being the TLR-free rate at 6 months after VAIVT.

Results: At the third procedure, 24 patients were treated with DCB (DCB group), whereas 26 were treated with SB (SB group). The TLR-free rates at 6 months and 1-year were significantly higher in the DCB group than in the SB group (79.2% vs 26.9%, p < .001; and 41.7% vs 7.7%, p = .005). In the DCB group, a significant correlation was observed between the TLR duration from VAIVT with DCB and the prerestenosis duration before DCB treatment.

Conclusions: Among patients with repeated short-term restenosis after VAIVT, DCB use significantly improved short-term patency compared with that after SB use. DCB may help extend the period between sessions, which are repeated in the short term, to an acceptable length.