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药物涂层球囊治疗透析动静脉内瘘反复短期再狭窄的疗效

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

作者信息

Maeda Takanori, Kuroda Koji, Takemoto Makoto, Fujimoto Wataru, Yamashita Soichiro, Imanishi Junichi, Iwasaki Masamichi, Todoroki Takafumi, Okuda Masanori

机构信息

Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan.

出版信息

Acta Radiol Open. 2025 Jun 19;14(6):20584601251352987. doi: 10.1177/20584601251352987. eCollection 2025 Jun.

Abstract

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%, < .001; and 41.7% vs 7.7%, = .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.

摘要

背景

药物涂层球囊(DCB)用于血管通路介入治疗(VAIVT)。然而,关于使用标准球囊(SB)进行VAIVT后短期反复再狭窄患者的研究报道较少,且DCB对这些患者通畅性的影响尚不清楚。

目的

本研究旨在评估DCB对VAIVT联合SB治疗后短期反复再狭窄患者的疗效。

材料与方法

这是一项单中心回顾性研究。我们纳入了50例在VAIVT联合SB治疗后6个月内连续发生两次再狭窄事件的患者。在第三次治疗中,患者接受DCB或SB治疗。在第三次治疗后1年评估靶病变血运重建(TLR),主要终点是VAIVT后6个月的无TLR率。

结果

在第三次手术中,24例患者接受DCB治疗(DCB组),26例患者接受SB治疗(SB组)。DCB组6个月和1年时的无TLR率显著高于SB组(79.2%对26.9%,<0.001;41.7%对7.7%,=0.005)。在DCB组中,观察到DCB进行VAIVT后的TLR持续时间与DCB治疗前的再狭窄持续时间之间存在显著相关性。

结论

在VAIVT后短期反复再狭窄的患者中,与使用SB相比,使用DCB显著改善了短期通畅性。DCB可能有助于将短期内重复进行的治疗间隔延长至可接受的长度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d553/12179460/d043f91cf959/10.1177_20584601251352987-fig1.jpg

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