Percutaneous transluminal cutting-balloon angioplasty for hemodialysis access stenoses resistant to conventional balloon angioplasty.

Purpose: To examine the value of cutting-balloon percutaneous transluminal angioplasty (PTA) for hemodialysis access with residual stenosis after conventional balloon PTA.

Material And Methods: Angioplasty with conventional balloons was performed on 48 hemodialysis access stenoses in 28 patients. If the balloon waist still remained at the rated burst pressure, the balloon was reinflated up to three times. Fifteen of 48 stenoses had residual stenoses of more than 30% after conventional balloon PTA. In these 15 stenoses, additional cutting-balloon PTA was performed.

Results: The mean residual percent diameter stenoses before and after conventional balloon PTA were 77.6+/-3.4% and 48.6+/-8.5%, respectively. Additional cutting-balloon PTA decreased the mean residual percent diameter to 27.9+/-10.0%, and the cutting balloon was completely inflated without complication. In 12 patients, the 6-month primary patency rate (+/-SE) was 90.0% (9.5), and the 1-year primary patency rate (+/-SE) was 25.0% (14.8).

Conclusion: Additional cutting-balloon PTA was found useful for reducing residual stenosis.