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Published on: July 9, 2020
Predilation-Free Scoring Paclitaxel-Coated Balloon Versus Conventional Plain Balloon Angioplasty for Failing
Dong-Ping Chen1, Ya-Xue Shi2, Hua Li3
1Department of Nephrology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Cardiovascular and Interventional Radiology
|June 29, 2026
Summary
Predilation-free angioplasty using a scoring paclitaxel-coated balloon improved 6-month patency for failing arteriovenous access. This method showed better results than conventional angioplasty without increasing adverse events.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Nephrology
Background:
- Arteriovenous access failure is a significant complication in hemodialysis patients.
- Conventional balloon angioplasty has limitations in maintaining long-term patency.
- Novel angioplasty techniques are needed to improve outcomes for failing arteriovenous access.
Purpose of the Study:
- To compare the efficacy and safety of predilation-free angioplasty with a scoring paclitaxel-coated balloon versus conventional plain balloon angioplasty.
- To evaluate the impact of this novel technique on target lesion primary patency in patients with failing arteriovenous access.
Main Methods:
- A prospective, multicenter, randomized controlled trial was conducted involving adults with malfunctioning arteriovenous fistulas or grafts.
- Participants were randomized to either predilation-free scoring paclitaxel-coated balloon angioplasty or conventional plain balloon angioplasty.
- The primary endpoint was 6-month target lesion primary patency, with secondary endpoints including safety and other patency measures.
Main Results:
- The scoring paclitaxel-coated balloon group demonstrated significantly higher 6-month target lesion primary patency (78.9% vs. 57.3%, P=0.004).
- While 12-month patency showed a trend favoring the scoring balloon, it did not reach statistical significance.
- No significant differences were observed in device success, procedural success, clinical success, mortality, or adverse events between the groups. Acute gain was greater, and residual stenosis was lower with the scoring paclitaxel-coated balloon.
Conclusions:
- Predilation-free angioplasty with a scoring paclitaxel-coated balloon is an effective strategy for improving short-term patency in failing arteriovenous access.
- This technique offers a safe alternative to conventional angioplasty, without an increase in adverse events.
- Further research may explore long-term outcomes and cost-effectiveness.
