Boitet Auréline, Massy Ziad A, Goeau-Brissonniere Olivier, Javerliat Isabelle, Coggia Marc, Coscas Raphaël
Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique, Hôpitaux de Paris, Boulogne-Billancourt, France; Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France.
Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France; Department of Nephrology, Ambroise Paré University Hospital, Assistance Publique, Hôpitaux de Paris, Boulogne-Billancourt, France; UMR 1018, Inserm-Paris11-CESP, Versailles Saint-Quentin-en-Yvelines University, Paris-Saclay University, Paul Brousse Hospital, 94807 Villejuif, France.
Semin Vasc Surg. 2016 Dec;29(4):178-185. doi: 10.1053/j.semvascsurg.2016.08.002. Epub 2016 Aug 11.
Maintaining vascular access patency represents a tremendous challenge in hemodialysis patients. Although "native" arteriovenous fistula (AVF) is currently recommended as primary vascular access, neointimal hyperplasia stenoses frequently develop, with a risk for AVF thrombosis and vascular access loss. For years, first-line treatment of AVFs stenoses has been percutaneous transluminal angioplasty, generally with high-pressure or cutting uncoated balloons. However, restenosis and reintervention rates remain incredibly high and occur, according to recent studies, in up to 60% and 70% of patients at 6 and 12 months, respectively. Drug-coated balloons delivering paclitaxel at the angioplasty site have proved their superiority in the treatment of coronary and peripheral arterial stenoses. Paclitaxel reduces neointimal hyperplasia and drug-coated balloons, therefore, it represents an attractive option for AVF stenoses. Because data are scarce, the aim of this paper was to review the concepts and current results of drug-coated balloons in AVF stenosis management.
维持血管通路通畅对血液透析患者而言是一项巨大挑战。尽管目前推荐“自体”动静脉内瘘（AVF）作为主要血管通路，但内膜增生狭窄仍频繁发生，存在AVF血栓形成及血管通路丧失的风险。多年来，AVF狭窄的一线治疗方法是经皮腔内血管成形术，通常使用高压或切割无涂层球囊。然而，再狭窄和再次干预率仍然极高，根据最近的研究，在6个月和12个月时，分别有高达60%和70%的患者出现这种情况。在血管成形术部位输送紫杉醇的药物涂层球囊已在冠状动脉和外周动脉狭窄的治疗中证明了其优越性。紫杉醇可减少内膜增生，因此，药物涂层球囊是治疗AVF狭窄的一个有吸引力的选择。由于数据稀少，本文旨在综述药物涂层球囊在AVF狭窄管理中的概念和当前结果。
