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Vessel Patency After Femoropopliteal Drug-Coated Balloon Therapy in Patients on Hemodialysis

Yasutaka Yamauchi1, Mitsuyoshi Takahara2, Yoshimitsu Soga3

  • 1Cardiovascular Center, Takatsu General Hospital, Kawasaki, Japan.

JACC. Cardiovascular Interventions
|July 16, 2025
PubMed

Insights

Drug-coated balloons (DCBs) offer a reasonable treatment for femoropopliteal lesions in hemodialysis (HD) patients. Restenosis risk factors in HD patients include poor runoff, prior therapy, lesion location, calcification, and specific balloon types.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Nephrology

Background:

  • Drug-coated balloons (DCBs) are a standard treatment for femoropopliteal lesions.
  • Large-scale prospective data on DCB use in hemodialysis (HD) patients is limited.

Purpose of the Study:

  • To assess restenosis risk after DCB therapy in patients undergoing hemodialysis.
  • To identify factors associated with restenosis in this patient population.

Main Methods:

  • Analysis of a multicenter prospective study database (March 2018-December 2019).
  • Inclusion of 991 lesions from patients on HD out of 3,165 total lesions.
  • Primary outcome: freedom from restenosis; propensity-score matching used for comparison.

Main Results:

  • Hemodialysis patients were younger but had higher rates of diabetes and chronic limb-threatening ischemia.
  • One-year freedom from restenosis was 82.2% in HD vs. 85.8% in non-HD; three-year rates were 61.9% vs. 66.3%.
  • Independent restenosis predictors in HD patients included no below-the-knee runoff, prior endovascular therapy, popliteal lesion, severe calcification, Lutonix use, and severe dissection.

Conclusions:

  • Drug-coated balloon angioplasty is a viable endovascular treatment option for femoropopliteal lesions in patients requiring hemodialysis.
  • Understanding specific risk factors is crucial for optimizing outcomes in this high-risk group.
Abstract

Keywords:
drug-coated balloonendovascular therapyfemoropopliteal diseasehemodialysislower extremity artery diseasepatency

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