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DOI: 10.1148/radiol.2491071845
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(Radiology 2008;249:375-381.)
© RSNA, 2008

Vascular and Interventional Radiology

Dialysis Access Venous Stenoses: Treatment with Balloon Angioplasty—1- versus 3-minute Inflation Times1

Andrew R. Forauer, MD, Eric K. Hoffer, MD, and Karen Homa, PhD

1 From the Departments of Vascular and Interventional Radiology (A.R.F., E.K.H.) and Preventive Medicine (K.H.), Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756. Received October 23, 2007; revision requested December 21; revision received February 25, 2008; accepted March 31; final version accepted April 17. Address correspondence to A.R.F. (e-mail: andrew.r.forauer{at}hitchcock.org).

Purpose: To examine prospectively the effects of balloon inflation time on the technical success of balloon angioplasty in dialysis access venous stenosis and on postintervention primary patency.

Materials and Methods: The study design was approved by the institution's Committee for the Protection of Human Subjects, and informed consent was obtained. Demographic information and access-specific data were collected. Patients with thrombosis, prior stent placement within the access circuit, and allergy to heparin were excluded. Patients were randomly assigned to a balloon inflation time of either 1 or 3 minutes. Balloon sizing, inflation pressure, balloon type, and heparin administration were controlled variables. The technical success of the angioplasty, defined as less than 30% residual stenosis, was evaluated for each lesion.

Results: A total of 48 patients were enrolled: 27 patients (40 stenoses) randomly assigned to the 1-minute group and 21 (36 stenoses) to the 3-minute group. There were no significant demographic differences between the two inflation groups. Technical success rates in the 1- and 3-minute inflation groups were 75% and 89%, respectively. Logistic regression analysis, which controlled for patient age, sex, and age of the access, demonstrated that technical success was 4.7 times more likely in the 3- versus the 1-minute inflation group (95% confidence interval: 1.1, 20.1). The 1-, 3-, and 6-month postintervention patencies were not significantly different between the two groups.

Conclusion: Although a 3-minute inflation time significantly improved the likelihood of technical success for percutaneous transluminal angioplasty of dialysis access venous stenoses, there was no significant difference in postintervention access patency.

© RSNA, 2008