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Metaanalysis of percutaneous cutting balloon angioplasty for the treatment of hemodialysis stenosis

  

  1. 1.Department of Nephrology,  Nanping First Hospital affiliated to Fujian Medical University, 
    Nanping 353000,  China;2.Department of Nephrology,  Tongji Hospital,  Tongji  Medical College, 
    Huazhong University  of  Science  and  Technology,  Wuhan  430000,  China
  • Online:2019-11-20 Published:2020-01-09
  • Contact: Corrsponding author: Yao Ying, Email:yaoyingdd@hotmail.com

Abstract: Objective  To evaluate the safety and efficacy of percutaneous cutting balloon angioplasty (PCB) in the treatment of hemodialysis stenosis,  and to provide reference and help for clinical treatment and related research. Methods  Databases such as Pubmed,  Embase,  Cochrane,  China Knowledge Network,  Wanfang,  and Weipu were searched up to August 2018 for relevant literature on hemodialysis stenosis and percutaneous balloon angioplasty (PTA). The document inclusion and exclusion criteria and evaluation criteria for effect indicators were given out. Two investigators independently screened the literature and evaluated the quality of the included literature with Cochrane Risk Bias Evaluation Tool. Results  A total of 58 relevant Chinese and foreign literatures were retrieved,  including four randomized clinical trials (RCT). The PCB and PTA results were compared headtohead: a total of 1 073 participants,  including 544 PCB and 529 PTA people. The 6month stenotic patency rate of PCB was significantly higher than that of PTA (65.93% vs 55.11%; RD=0.11; 95%CI: 0.050.16; P=0.0002).  There was no statistically significant difference in the success rate of PCB versus PTA (87.68% vs 84.31%; RD=0.03; 95%CI:-0.010.08; P=0.10).There was no statistically significant difference in complications rates of PCB and PTA (0.026% vs 0.004%; RD=0.03; 95%CI:-0.010.07; P=0.19). Conclusion  PCB treatment of hemodialysis pathway stenosis has good efficacy and safety; it is an ideal choice in the treatment of hemodialysis stenosis.

Key words: vascular access, angioplasty, metaanalysis