Abstract No. 213 Cephalic Arch Stenosis in Vascular Access: Single-Center Experience of 90 Procedures

This is a single-center retrospective analysis to evaluate the effectiveness of endovascular procedures for the treatment of dysfunctional vascular access with cephalic arch stenosis (CAS). Between August 2017 and December 2021 (41 months) 56 patients (41 men, mean age 69 years) with available data, underwent 90 procedures for the treatment of their dysfunctional vascular access owed to CAS. Most frequent comorbidities were hypertension and smoking. Patients were treated with High-Pressure Balloon (HPB) angioplasty only (HPB-group), Paclitaxel-Coated Balloon (PCB) angioplasty (PCB-group) or Covered Stent (CS) insertion (CS-group). When used, PCBs and CS were a second line treatment and predilation with a HPB was performed. Primary outcome measures were target lesion primary patency (TLPP) at 6 months assessed with Kaplan-Meier survival analysis and procedural success defined as resumption of dialysis. Procedural success was 100%. Mean follow-up was 643 ± 468 days. HPB angioplasty was performed in 50 cases (50/90, 55.5%), PCBs were used in 14 cases (14/90, 15.6%) and CS were used in 26 cases (26/90, 28.9%). TLPP at 6 months was 54% for the HPB-group, 78.57% for the PCB group and 80.77% for CS-group (p< 0.0001) and 31.9%, 64.3% and 76.9% at 12 months respectively. In this retrospective analysis PCBs and CSs had similar results for the treatment of CAS and significantly better to HPB angioplasty.