Effectiveness of stent graft versus balloon angioplasty for failing arteriovenous dialysis graft—a single center retrospective cohort experience

Background: Evaluating stent graft (SG) and balloon angioplasty for the treatment of failing arteriovenous dialysis graft (AVG). Methods: Retrospectively analyze the clinical variables, treatment methods, and follow-up results of 43 patients, whose AVG was failed from March 2014 to December 2016. According to whether to carry out SG implantation, patients were classified into two groups. Then we compare the clinical feature between the two groups. Results: The stenosis rate of target lesion (79.79%±9.58% vs . 78.65%±10.20%, P=0.709), target lesion length (2.78±0.91 vs . 3.29±1.02 cm, P=0.090) and reference vessel diameter (5.68±0.59 vs . 5.76±0.77 mm, P=0.696) were similar in the two groups. Both the 6- and 12-month postintervention primary patency rate of target lesion in SG group were superior compared with percutaneous transluminal angioplasty (PTA) group (60% vs . 30.34%, P=0.037; 20% vs . 0%, P=0.037). The postintervention 6-month assisted primary patency rate was 70% in SG group and 34.78% in PTA group (P=0.037). The postintervention 6-month secondary patency rate in both SG and PTA were 100%, and the postintervention 12-month secondary patency rate were similar in the two groups (90% vs . 95.65%, P=0.491). The 12-month postintervention index of patency function was 6.90±2.71 (months/intervention) for SG group and 4.96±1.15 for PTA group (P=0.003). Conclusions: SG is superior to solely PTA regarding 6- and 12-month patency rate in treating AVG failure. Whether routine surveillance and pharmacological treatment for AVG should be carried out need further investigation.