OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of scoring balloons (SBs) versus high-pressure balloons (HPBs) in the treatment of autologous arteriovenous fistula dysfunction (AAFD) and to provide evidence for balloon catheter selection in clinical practice. MATERIALS AND METHODS: A total of 79 patients with AAFD who underwent percutaneous transluminal angioplasty (PTA) between January 2023 and December 2023 were retrospectively enrolled. According to the type of balloon used during the procedure, patients were divided into the SB group ( n = 27) and the HPB group ( n = 52). Outcomes included anatomical success, clinical success, primary patency rates at 3, 6, 9, and 12 months, procedure-related complications, and hospitalization-related medical costs. Kaplan–Meier survival analysis was performed to compare postintervention primary patency between the groups, and Cox proportional hazards regression was used to identify factors associated with primary patency. RESULTS: There were no statistically significant differences between the two groups with respect to baseline characteristics. Both the groups achieved 100% anatomical and clinical success rates, with comparable safety profiles, and no procedure-related complications such as vascular rupture or dissection were observed ( P > 0.05). There was no significant difference in primary patency at 3 months between the two groups (SB: 92.59% vs. HPB: 90.38%, P > 0.05). However, the SB group demonstrated a significantly higher primary patency rate at 6 months (85.19% vs. 59.62%, P = 0.020) and showed a trend toward higher primary patency at 9 months (66.67% vs. 44.23%, P = 0.058) and 12 months (59.26% vs. 36.54%, P = 0.054). Kaplan–Meier analysis confirmed a higher cumulative primary patency in the SB group (hazard ratio HR = 0.509; 95% confidence interval CI, 0.257–1.008; P = 0.048). Multivariate analysis identified SB use as an independent protective factor for primary patency (HR = 0.46; 95% CI, 0.23–0.92; P = 0.027). Regarding healthcare resource utilization, the procedural consumable cost was significantly higher in the SB group (CNY: 12,744.3 vs. 7477.0, P = 0.006), whereas total hospitalization cost (CNY: 25,898.0 vs. 25,011.5) and length of hospital stay (5.0 vs. 5.5 days) did not differ significantly between the groups ( P > 0.05). CONCLUSION: SB and HPB angioplasty showed comparable safety in the treatment of arteriovenous access flow dysfunction. Although SB was associated with a significantly higher 6-month primary patency rate, the effect estimate remains limited by the small sample size, and its mid- and long-term efficacy (>6 months) requires confirmation in larger studies with longer follow-up.
Luo et al. (Thu,) studied this question.
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