Objective To evaluate the efficacy of paclitaxel-coated balloon (PCB) angioplasty in treating recurrent stenosis of vascular access and investigate risk factors affecting target lesion patency time.
Methods A retrospective study included 81 patients with recurrent stenosis of vascular access. The patients were divided into the PCB group (n = 40) and conventional high-pressure balloon (HPB)group (n = 41) based on treatment methods. The study compared surgical techniques, clinical success rates, preoperative/postoperative stenotic diameter, dialysis blood flow, primary stenosis patency rates at 1, 3, 6, 9, and 12 months, postoperative complications within 1 month, and potential risk factors.
Results No statistically significant differences were observed in preoperative stenotic diameter or dialysis blood flow between the two groups (P ＞ 0.05). The PCB group showed significantly better postoperative stenotic diameter and dialysis blood flow compared to the HPB group (P ＜ 0.05). The median postoperative stenosis patency time was 5.55 months in the PCB group versus 4.90 months in the HPB group (Z = 1.27, P ＞ 0.05). No statistically significant differences were found in primary stenosis patency rates at 1, 3, 6, 9, and 12 months (P ＞ 0.05), nor in postoperative complication rates within 1 month (P ＞ 0.05). Cox regression analysis revealed that the number of stenotic lesions at 12 months postoperatively was an independent risk factor for postoperative stenosis patency time (HR = 0.598, 95%CI: 0.370–0.966, P ＜ 0.05).
Conclusions Compared with conventional HPB angioplasty, PCB angioplasty demonstrates certain advantages in treating recurrent stenosis of vascular access. It effectively dilates the stenotic area and increases dialysis blood flow, making it a safe and effective option for managing recurrent stenosis. The number of stenotic sites is a risk factor affecting the patency duration of the vascular access postoperatively.
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