Efficacy of cutting balloon angioplasty versus high-pressure balloon angioplasty for the treatment of arteriovenous fistula stenoses in patients undergoing hemodialysis: Systematic review and meta-analysis

PLoS One. 2024 Jan 25;19(1):e0296191. doi: 10.1371/journal.pone.0296191. eCollection 2024.

Abstract

This systematic review and meta-analysis aimed to assess and compare the therapeutic outcomes of cutting balloon angioplasty and high-pressure balloon angioplasty for arteriovenous fistula stenosis in hemodialysis patients. All studies indexed in PubMed, Embase, and Cochrane Library Web of Science were retrieved. The retrieval deadline was July 15, 2023. Risk of bias 2.0 was used to evaluate the quality of the included studies. Revman 5.4 software was used for data analysis. This review included three studies and 180 patients, with 90 patients in the cutting balloon angioplasty group and 90 patients in the high-pressure balloon angioplasty group. The results of the meta-analysis suggested that compared with high-pressure balloon angioplasty, cutting balloon angioplasty can improve primary lesion patency rates of internal arteriovenous fistulas at 6 months (relative risk, 1.45; 95% confidence interval, 1.08-1.96; P = 0.01). However, there were no significant differences between the technical success rate (relative risk, 0.99; 95% confidence interval, 0.93-1.05; P = 0.72) and clinical success rate (relative risk, 1.01; 95% confidence interval, 0.95-1.07; P = 0.73). Therefore, cutting balloon angioplasty is likely to increase primary lesion patency rates at 6 months. However, more high-quality, large-sample, multicenter, randomized controlled trials are needed for further validation due to the limited number of included studies.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Angioplasty, Balloon* / methods
  • Arteriovenous Fistula* / therapy
  • Arteriovenous Shunt, Surgical* / adverse effects
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy
  • Humans
  • Multicenter Studies as Topic
  • Renal Dialysis
  • Treatment Outcome
  • Vascular Patency

Grants and funding

Traditional Chinese Medicine Evidence Based Ability Enhancement Project 2023. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.