Single-Center Prospective Pilot Study of Sirolimus Drug-Coated Balloon Angioplasty in Maintaining the Patency of Thrombosed Arteriovenous Graft
Autor: | Chee Wooi Tan, Alvin Ren Kwang Tng, Kun Da Zhuang, Tze Tec Chong, Ru Yu Tan, Jasmine Ming Er Chua, Suh Chien Pang, Tjun Y. Tang, Chieh Suai Tan, Kiang Hiong Tay |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Pilot Projects Single Center Balloon 030218 nuclear medicine & medical imaging Blood Vessel Prosthesis Implantation 03 medical and health sciences Arteriovenous Shunt Surgical 0302 clinical medicine Coated Materials Biocompatible Recurrence Renal Dialysis Risk Factors Angioplasty medicine Humans Vascular Patency Radiology Nuclear Medicine and imaging Prospective Studies Adverse effect Vein Prospective cohort study Aged Thrombectomy Sirolimus business.industry Graft Occlusion Vascular Cardiovascular Agents Thrombosis Middle Aged Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female Cardiology and Cardiovascular Medicine business Angioplasty Balloon Vascular Access Devices medicine.drug |
Zdroj: | Journal of Vascular and Interventional Radiology. 32:369-375 |
ISSN: | 1051-0443 |
Popis: | Purpose To investigate the use of a sirolimus drug-coated balloon (DCB) in the management of a thrombosed arteriovenous graft (AVG). Materials and Methods A single-center prospective pilot study was conducted between October 2018 and October 2019. Twenty patients (age = 67.0 years ± 10; male = 35%; mean time on dialysis = 31 months) with thrombosed upper limb AVG were enrolled. After successful pharmacomechanical thrombectomy and adequate treatment of the graft vein junction, sirolimus DCB angioplasty was performed at the graft vein junction. The patients were followed-up for 6 months, and all adverse events occurring during the study period were recorded. Results The primary circuit patency rates at 3 and 6 months were 76% and 65%, respectively, while the assisted-primary circuit patency rates at 3 and 6 months were 82% and 65%, respectively. The 3- and 6-month secondary circuit patency rates were 88% and 76%, respectively. Using Kaplan-Meier analyses, the estimated mean primary, assisted-primary, and secondary patencies were 285 days (95% confidence interval (CI) = 194–376 days), 319 days (95% CI = 221–416 days), and 409 days (95% CI = 333–485 days). No adverse event directly related to sirolimus DCB use was observed. Conclusions The results of this pilot study suggest that the application of sirolimus DCB at the graft vein junction after the successful thrombectomy of AVG may be a feasible option to improve patency outcomes. |
Databáze: | OpenAIRE |
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