NOTE: This video is ONLY available to watch in selected countries and geographies [geoip-content country=”AL, AD, AT, BY, BE, BA, BG, HR, CY, CZ, DK, EE, FI, FR, DE, GR, HU, IS, IE, IT, LV, LI, LT, LU, MT, MD, MC, ME, NL, MK, NO, PL, PT, RO, RU, SM, RSz SK, SI, ES, SE, CH, UA, GB, VA”]Kate Steiner (East and North Hertfordshire NHS Trust, Stevenage, UK) and Matteo Tozzi (University of Insubria, Varese, Italy) discuss the growing body of evidence for treating arteriovenous (AV) fistula lesions with drug-coated balloon (DCB) therapy. Attention is increasingly turning to how lesion type influences outcomes, and where DCBs can deliver the greatest benefit.
Steiner and Tozzi first share their perspectives on the IN.PACT AV Access results across lesion types, with Steiner remarking that the data from the trial offer “high-quality, level-one evidence that DCBs are effective in treating AV access stenosis”.
The pair also discuss how de novo stenosis represents a suitable target for DCB therapy. Despite a lack of clinical evidence specifically focused on this type of lesion, Steiner explains the rationale for DCB treatment: “Now we know that some lesion types have intimal hyperplasia […] then it makes scientific sense that by applying paclitaxel to those lesions, we’re targeting the intimal hyperplasia, and that should have a good result”.
Tozzi adds that, in his clinical experience, DCB treatment of de novo lesions prolongs the time to restenosis compared to treatment with plain balloon angioplasty. As a result, they both agree that DCBs should be a first-line treatment for de novo lesions, as reducing the number of reinterventions is critical to improving patients’ quality of life.
In conclusion, both experts emphasise the importance of a multidisciplinary team, including nephrologists, nurses, and interventional radiologists, supported by structured follow-up and robust clinical pathways to treat patients in a timely fashion.
This video is sponsored by Medtronic[/geoip-content]
