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
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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