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Abstract
This study aimed to compare stent graft with balloon tamponade for ruptured dialysis access during percutaneous transluminal angioplasty. Patients over an 8-year period (2010–2018) were identified from a database of 11,609 procedures. The primary endpoint was target lesion primary patency at 12 months. A total of 143 patients who had rupture dialysis access were enrolled, of whom 52 were salvaged by stent grafts and 91 were salvaged by balloon tamponade. The 6-month target lesion primary patency was greater in the stent graft group than in the balloon tamponade group (66.7% vs. 29.5%, P < 0.001). The benefit of stent grafts was sustained for 12 months (52.5% vs. 9.0%, P < 0.001). The stent grafts increased the median time from the index procedure to the next intervention in the ruptured area by 171 days (260 vs. 89 days) at 12 months. There was no significant difference in the access circuit patency rates at 6 months (25.5% vs. 19.8%, P = 0.203) and 12 months (12.0% vs. 5.8%, P = 0.052). The patency results of the stent grafts remained after the multivariable adjustment analysis. Compared to balloon tamponade alone, stent grafts provided superior target lesion primary patency at 6 and 12 months. The access circuit patency rates were similar.
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1 National Taiwan University Hospital Hsinchu Branch, Division of Cardiology, Department of Medicine, Hsinchu, Taiwan, ROC (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University, College of Medicine, Taipei, Taiwan, ROC (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241)
2 National Taiwan University, College of Medicine, Taipei, Taiwan, ROC (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Taiwan University Hospital, Hsinchu Branch, Division of Cardiovascular Surgery, Department of Surgery, Hsinchu, Taiwan, ROC (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815)
3 National Taiwan University Hospital Hsinchu Branch, Division of Cardiology, Department of Medicine, Hsinchu, Taiwan, ROC (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815)
4 National Taiwan University Hospital Hsinchu Branch, Division of Cardiology, Department of Medicine, Hsinchu, Taiwan, ROC (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University, College of Medicine, Taipei, Taiwan, ROC (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Yang Ming Chiao Tung University, Institute of Biological Science and Technology, Taipei, Taiwan, ROC (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017)
5 Taipei Veteran General Hospital, Division of Nephrology, Department of Medicine, Taipei, Taiwan, ROC (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
6 National Taiwan University Hospital, Department of Family Medicine, Taipei, Taiwan, ROC (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University, School of Public Health, Taipei, Taiwan, ROC (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241)
7 National Yang Ming Chiao Tung University, Institute of Biological Science and Technology, Taipei, Taiwan, ROC (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Taipei Medical University and Hospital, Division of Cardiology, Department of Medicine, Taipei, Taiwan, ROC (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994)
8 National Taiwan University, College of Medicine, Taipei, Taiwan, ROC (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Tsing-Hua University, Institute of Biomedical Engineering, Hsinchu, Taiwan, ROC (GRID:grid.38348.34) (ISNI:0000 0004 0532 0580); National Health Research Institute, Institute of Cellular and System Medicine, Zhunan, Taiwan, ROC (GRID:grid.59784.37) (ISNI:0000000406229172); National Taiwan University Hospital Hsinchu Branch, Cardiovascular Center, Hsinchu City, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815)