Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Paclitaxel-Coated Balloon Angioplasty for Early Restenosis of Central Veins in Hemodialysis Patients: A Single Center Initial Experience

  • Hongsakul, Keerati (Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University) ;
  • Bannangkoon, Kittipitch (Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University) ;
  • Rookkapan, Sorracha (Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University) ;
  • Boonsrirat, Ussanee (Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University) ;
  • Kritpracha, Boonprasit (Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University)
  • Received : 2017.08.02
  • Accepted : 2017.10.01
  • Published : 2018.06.01
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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 $65.8{\pm}14.4$ 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 paclitaxelcoated 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 $3.7{\pm}2.4mm$ before the procedure vs. $11.4{\pm}1.8mm$ after the initial procedure. There were no procedure-related complications. The mean diameters of the central veins at 6 months and 12 months were $7.8{\pm}1.3mm$ and $6.9{\pm}2.7mm$, 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 paclitaxelcoated 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.

Keywords

References

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