Comparison between the 0- and 30-s balloon dilation time in percutaneous transluminal angioplasty for restenosed arteriovenous fistula among hemodialysis patients: a multicenter, prospective, randomized trial (CARP study)

Background This study aims to compare patency rates of the 0- and 30-s (sec) balloon dilation time in hemodialysis (HD) patients with restenosis after percutaneous transluminal angioplasty (PTA).

Methods The patients who underwent PTA within 6 months for failed arteriovenous fistula at the forearm were randomly assigned the 0-s or 30-s dilation time group.

Effect of dilation time on the 3- and 6-month patency rates after PTA was examined.

Results Fifty patients were enrolled in this study.

The 3-month patency rate in the 30-s dilation group was better than that in the 0-s dilation group ( P  = 0.0050), while the 6-month patency rates did not show a significant difference between the two groups ( P  = 0.28).

Cox’s proportional hazard model revealed that 30-s of inflation time (hazard ratio 0.027; P  = 0.0072), diameter of the proximal (hazard ratio 0.32; P  = 0.031), and dilation pressure (hazard ratio 0.63; P  = 0.014) were associated with better 3-month patency.

Dilation pressure between previous and present PTA did not differ in the 0-s ( P  = 0.15) and 30-s dilation groups ( P  = 0.16).

The 6-month patency rate of the present PTA in the 30-s dilation group was higher than that of the previous PTA ( P  = 0.015).

The visual analog scale did not differ between the two groups ( P  = 0.51).

Conclusion The presenting data suggest that 30-s dilation potentially results in a better 3-month patency rate than 0-s dilation in HD patients with restenosis after PTA.