Drug-Coated Balloons Boost Short-Term Dialysis Access, Study Finds

For patients relying on haemodialysis, the arteriovenous fistula (AVF)—a surgical connection between an artery and a vein—is a critical lifeline. However, these access points frequently suffer from stenosis, or narrowing, which restricts blood flow. A new systematic review and meta-analysis of 21 randomised controlled trials has evaluated whether drug-coated balloons (DCB) offer a superior solution to traditional plain balloon angioplasty (PBA).

The study, which synthesised data from 2,537 patients, found that DCBs significantly outperformed plain balloons in the short to medium term. Specifically, the drug-coated option more than doubled the odds of the vessel remaining open (primary patency) at six months and maintained a clear advantage at the one-year mark. The medication on the balloon helps prevent the rapid regrowth of tissue that typically causes the vessel to narrow again.

However, this superior efficacy appears to be temporary. The analysis revealed that by 24 months, the benefit had attenuated, with no significant statistical difference in outcomes between the two groups. Importantly, safety remains comparable, with no increase in complications or mortality associated with the drug-coated devices.

Given that DCBs come with a higher initial price tag, the authors suggest a personalised approach. Clinicians should weigh the distinct short-term benefits against the cost, considering the patient's life expectancy and the specific characteristics of the lesion before choosing the treatment path.