A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis
AbstractBackgroundArteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis. MethodsThis study has been...
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| Veröffentlicht in: | Journal of vascular surgery 2019-09, Vol.70 (3), p.970-979.e3 |
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| creator | Yan Wee, Ian Jun Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg) Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS Lee Qingwei, Shaun, MBBS Tan, Chieh Suai, MBBS Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI |
| description | AbstractBackgroundArteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis. MethodsThis study has been performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search on MEDLINE, Embase, and the Cochrane Library was performed to identify articles evaluating DCB angioplasty for patients with HD access stenosis. Risk ratios (RRs) of primary patency were pooled, and relevant subgroup and sensitivity analyses were conducted. ResultsThere were 17 studies (8 randomized controlled trials [RCTs], 9 cohort studies) included, comprising a total of 1113 stenotic dialysis accesses, of which 54.7% underwent DCB angioplasty and 45.3% underwent CBA. There was a significantly superior 6-month (RR, 0.57; 95% confidence interval [CI], 0.44-0.74; P < .00001; I2 = 62%) and 12-month (RR, 0.73; 95% CI, 0.63-0.84; P < .0001; I2 = 53%) primary patency in the DCB angioplasty group in comparison to the CBA group (71.0% vs 49.2% at 6 months; 44.2% vs 20.6% at 12 months). Subgroup analyses of study design (RCTs, cohort studies) showed similar trends. Sensitivity analyses by excluding one poor-quality RCT and those employing the crossover analysis design also showed similar results. Studies investigating central venous stenosis showed significantly better 6-month (RR, 0.57; 95% CI, 0.41-0.79; P = .0009; I2 = 67%) and 12-month (RR, 0.69; 95% CI, 0.56-0.85; P = .0004; I2 = 64%) primary patency in the DCB angioplasty group in comparison to the CBA group. The pooled rate of minor complications was low in both the DCB (1.1%) and CBA (0.9%) groups. ConclusionsDCB angioplasty appears to be a better and safe alternative to CBA in treating patients with HD stenosis in terms of 6- and 12-month primary patency. However, a larger trial is warranted to establish these findings. |
| doi_str_mv | 10.1016/j.jvs.2019.01.082 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2280529731</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S074152141930357X</els_id><sourcerecordid>2280529731</sourcerecordid><originalsourceid>FETCH-LOGICAL-c451t-a67d246fc655b4d5f89f2ee522891c6ffc9208caa58aa73e2c61b6e1f32fcf403</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhoMo7rj6A7xIjl66TaU7_YEgLIu6CwseVPAWMunKkrYnGVPds_TRf26GGffgwVMIed431FOMvQZRgoDm3ViOByqlgL4UUIpOPmEbEH1bNJ3on7KNaGsolIT6gr0gGoUAUF37nF1UUNeqUbBhv684rTTjzsze8oQHjw_chIHvcDaFCWZayROPjg9puS9sNDMOfGumKcbAD5hoIW5jOGCYfcz445sJ9z7uJ0Pzyl1MfPDnLmMtEvH8aYj5_pI9c2YifHU-L9n3Tx-_Xd8Ud18-315f3RW2VjAXpmkHWTfONkpt60G5rncSUUnZ9WAb52wvRWeNUZ0xbYXSNrBtEFwlnXW1qC7Z21PvPsVfC9Ksd54sTpMJGBfSuUgo2bcVZBROqE2RKKHT--R3Jq0ahD6a16PO5vXRvBags_mceXOuX7Y7HB4Tf1Vn4P0JwDxk1pw0WY_B4uAT2lkP0f-3_sM_aTv54K2ZfuKKNMYlZfmkQZPUQn89rv64eegrUan2R_UHoyyskw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2280529731</pqid></control><display><type>article</type><title>A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Yan Wee, Ian Jun ; Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg) ; Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS ; Lee Qingwei, Shaun, MBBS ; Tan, Chieh Suai, MBBS ; Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS ; Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</creator><creatorcontrib>Yan Wee, Ian Jun ; Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg) ; Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS ; Lee Qingwei, Shaun, MBBS ; Tan, Chieh Suai, MBBS ; Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS ; Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</creatorcontrib><description>AbstractBackgroundArteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis. MethodsThis study has been performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search on MEDLINE, Embase, and the Cochrane Library was performed to identify articles evaluating DCB angioplasty for patients with HD access stenosis. Risk ratios (RRs) of primary patency were pooled, and relevant subgroup and sensitivity analyses were conducted. ResultsThere were 17 studies (8 randomized controlled trials [RCTs], 9 cohort studies) included, comprising a total of 1113 stenotic dialysis accesses, of which 54.7% underwent DCB angioplasty and 45.3% underwent CBA. There was a significantly superior 6-month (RR, 0.57; 95% confidence interval [CI], 0.44-0.74; P < .00001; I2 = 62%) and 12-month (RR, 0.73; 95% CI, 0.63-0.84; P < .0001; I2 = 53%) primary patency in the DCB angioplasty group in comparison to the CBA group (71.0% vs 49.2% at 6 months; 44.2% vs 20.6% at 12 months). Subgroup analyses of study design (RCTs, cohort studies) showed similar trends. Sensitivity analyses by excluding one poor-quality RCT and those employing the crossover analysis design also showed similar results. Studies investigating central venous stenosis showed significantly better 6-month (RR, 0.57; 95% CI, 0.41-0.79; P = .0009; I2 = 67%) and 12-month (RR, 0.69; 95% CI, 0.56-0.85; P = .0004; I2 = 64%) primary patency in the DCB angioplasty group in comparison to the CBA group. The pooled rate of minor complications was low in both the DCB (1.1%) and CBA (0.9%) groups. ConclusionsDCB angioplasty appears to be a better and safe alternative to CBA in treating patients with HD stenosis in terms of 6- and 12-month primary patency. However, a larger trial is warranted to establish these findings.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2019.01.082</identifier><identifier>PMID: 31445651</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon - adverse effects ; Angioplasty, Balloon - instrumentation ; Arteriovenous Shunt, Surgical - adverse effects ; Cardiovascular Agents - administration & dosage ; Cardiovascular Agents - adverse effects ; Central venous stenosis ; Coated Materials, Biocompatible ; Conventional balloon angioplasty ; Dialysis access stenosis ; Drug-coated balloon ; Equipment Design ; Female ; Graft Occlusion, Vascular - etiology ; Graft Occlusion, Vascular - physiopathology ; Graft Occlusion, Vascular - therapy ; Humans ; Male ; Middle Aged ; Renal Dialysis ; Risk Factors ; Surgery ; Time Factors ; Treatment Outcome ; Vascular Access Devices ; Vascular Patency</subject><ispartof>Journal of vascular surgery, 2019-09, Vol.70 (3), p.970-979.e3</ispartof><rights>Society for Vascular Surgery</rights><rights>2019 Society for Vascular Surgery</rights><rights>Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-a67d246fc655b4d5f89f2ee522891c6ffc9208caa58aa73e2c61b6e1f32fcf403</citedby><cites>FETCH-LOGICAL-c451t-a67d246fc655b4d5f89f2ee522891c6ffc9208caa58aa73e2c61b6e1f32fcf403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S074152141930357X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31445651$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yan Wee, Ian Jun</creatorcontrib><creatorcontrib>Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg)</creatorcontrib><creatorcontrib>Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS</creatorcontrib><creatorcontrib>Lee Qingwei, Shaun, MBBS</creatorcontrib><creatorcontrib>Tan, Chieh Suai, MBBS</creatorcontrib><creatorcontrib>Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS</creatorcontrib><creatorcontrib>Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</creatorcontrib><title>A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>AbstractBackgroundArteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis. MethodsThis study has been performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search on MEDLINE, Embase, and the Cochrane Library was performed to identify articles evaluating DCB angioplasty for patients with HD access stenosis. Risk ratios (RRs) of primary patency were pooled, and relevant subgroup and sensitivity analyses were conducted. ResultsThere were 17 studies (8 randomized controlled trials [RCTs], 9 cohort studies) included, comprising a total of 1113 stenotic dialysis accesses, of which 54.7% underwent DCB angioplasty and 45.3% underwent CBA. There was a significantly superior 6-month (RR, 0.57; 95% confidence interval [CI], 0.44-0.74; P < .00001; I2 = 62%) and 12-month (RR, 0.73; 95% CI, 0.63-0.84; P < .0001; I2 = 53%) primary patency in the DCB angioplasty group in comparison to the CBA group (71.0% vs 49.2% at 6 months; 44.2% vs 20.6% at 12 months). Subgroup analyses of study design (RCTs, cohort studies) showed similar trends. Sensitivity analyses by excluding one poor-quality RCT and those employing the crossover analysis design also showed similar results. Studies investigating central venous stenosis showed significantly better 6-month (RR, 0.57; 95% CI, 0.41-0.79; P = .0009; I2 = 67%) and 12-month (RR, 0.69; 95% CI, 0.56-0.85; P = .0004; I2 = 64%) primary patency in the DCB angioplasty group in comparison to the CBA group. The pooled rate of minor complications was low in both the DCB (1.1%) and CBA (0.9%) groups. ConclusionsDCB angioplasty appears to be a better and safe alternative to CBA in treating patients with HD stenosis in terms of 6- and 12-month primary patency. However, a larger trial is warranted to establish these findings.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty, Balloon - adverse effects</subject><subject>Angioplasty, Balloon - instrumentation</subject><subject>Arteriovenous Shunt, Surgical - adverse effects</subject><subject>Cardiovascular Agents - administration & dosage</subject><subject>Cardiovascular Agents - adverse effects</subject><subject>Central venous stenosis</subject><subject>Coated Materials, Biocompatible</subject><subject>Conventional balloon angioplasty</subject><subject>Dialysis access stenosis</subject><subject>Drug-coated balloon</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Graft Occlusion, Vascular - etiology</subject><subject>Graft Occlusion, Vascular - physiopathology</subject><subject>Graft Occlusion, Vascular - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Renal Dialysis</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Access Devices</subject><subject>Vascular Patency</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo7rj6A7xIjl66TaU7_YEgLIu6CwseVPAWMunKkrYnGVPds_TRf26GGffgwVMIed431FOMvQZRgoDm3ViOByqlgL4UUIpOPmEbEH1bNJ3on7KNaGsolIT6gr0gGoUAUF37nF1UUNeqUbBhv684rTTjzsze8oQHjw_chIHvcDaFCWZayROPjg9puS9sNDMOfGumKcbAD5hoIW5jOGCYfcz445sJ9z7uJ0Pzyl1MfPDnLmMtEvH8aYj5_pI9c2YifHU-L9n3Tx-_Xd8Ud18-315f3RW2VjAXpmkHWTfONkpt60G5rncSUUnZ9WAb52wvRWeNUZ0xbYXSNrBtEFwlnXW1qC7Z21PvPsVfC9Ksd54sTpMJGBfSuUgo2bcVZBROqE2RKKHT--R3Jq0ahD6a16PO5vXRvBags_mceXOuX7Y7HB4Tf1Vn4P0JwDxk1pw0WY_B4uAT2lkP0f-3_sM_aTv54K2ZfuKKNMYlZfmkQZPUQn89rv64eegrUan2R_UHoyyskw</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Yan Wee, Ian Jun</creator><creator>Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg)</creator><creator>Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS</creator><creator>Lee Qingwei, Shaun, MBBS</creator><creator>Tan, Chieh Suai, MBBS</creator><creator>Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS</creator><creator>Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190901</creationdate><title>A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis</title><author>Yan Wee, Ian Jun ; Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg) ; Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS ; Lee Qingwei, Shaun, MBBS ; Tan, Chieh Suai, MBBS ; Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS ; Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-a67d246fc655b4d5f89f2ee522891c6ffc9208caa58aa73e2c61b6e1f32fcf403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty, Balloon - adverse effects</topic><topic>Angioplasty, Balloon - instrumentation</topic><topic>Arteriovenous Shunt, Surgical - adverse effects</topic><topic>Cardiovascular Agents - administration & dosage</topic><topic>Cardiovascular Agents - adverse effects</topic><topic>Central venous stenosis</topic><topic>Coated Materials, Biocompatible</topic><topic>Conventional balloon angioplasty</topic><topic>Dialysis access stenosis</topic><topic>Drug-coated balloon</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Graft Occlusion, Vascular - etiology</topic><topic>Graft Occlusion, Vascular - physiopathology</topic><topic>Graft Occlusion, Vascular - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Renal Dialysis</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Access Devices</topic><topic>Vascular Patency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yan Wee, Ian Jun</creatorcontrib><creatorcontrib>Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg)</creatorcontrib><creatorcontrib>Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS</creatorcontrib><creatorcontrib>Lee Qingwei, Shaun, MBBS</creatorcontrib><creatorcontrib>Tan, Chieh Suai, MBBS</creatorcontrib><creatorcontrib>Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS</creatorcontrib><creatorcontrib>Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yan Wee, Ian Jun</au><au>Yap, Hao Yun, MBBS, MRCSEd (Surgery), MMed (Surgery), FRCSEd (Gen Surg)</au><au>Hsien Ts'ung, Luke Tay, MBBS, MSc, MRCS, FRCS</au><au>Lee Qingwei, Shaun, MBBS</au><au>Tan, Chieh Suai, MBBS</au><au>Tang, Tjun Yip, MA (Cantab), MB BChir, MD, FRCS (Gen), FAMS</au><au>Chong, Tze Tec, MBBS, FACS (General and Vascular Surgery), RPVI</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>70</volume><issue>3</issue><spage>970</spage><epage>979.e3</epage><pages>970-979.e3</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>AbstractBackgroundArteriovenous fistulas for patients undergoing hemodialysis (HD) are at high risk of stenosis. Despite conventional balloon angioplasty (CBA), restenosis rates are high. The use of a drug-coated balloon (DCB) may offer an alternative to reduce restenosis. MethodsThis study has been performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic search on MEDLINE, Embase, and the Cochrane Library was performed to identify articles evaluating DCB angioplasty for patients with HD access stenosis. Risk ratios (RRs) of primary patency were pooled, and relevant subgroup and sensitivity analyses were conducted. ResultsThere were 17 studies (8 randomized controlled trials [RCTs], 9 cohort studies) included, comprising a total of 1113 stenotic dialysis accesses, of which 54.7% underwent DCB angioplasty and 45.3% underwent CBA. There was a significantly superior 6-month (RR, 0.57; 95% confidence interval [CI], 0.44-0.74; P < .00001; I2 = 62%) and 12-month (RR, 0.73; 95% CI, 0.63-0.84; P < .0001; I2 = 53%) primary patency in the DCB angioplasty group in comparison to the CBA group (71.0% vs 49.2% at 6 months; 44.2% vs 20.6% at 12 months). Subgroup analyses of study design (RCTs, cohort studies) showed similar trends. Sensitivity analyses by excluding one poor-quality RCT and those employing the crossover analysis design also showed similar results. Studies investigating central venous stenosis showed significantly better 6-month (RR, 0.57; 95% CI, 0.41-0.79; P = .0009; I2 = 67%) and 12-month (RR, 0.69; 95% CI, 0.56-0.85; P = .0004; I2 = 64%) primary patency in the DCB angioplasty group in comparison to the CBA group. The pooled rate of minor complications was low in both the DCB (1.1%) and CBA (0.9%) groups. ConclusionsDCB angioplasty appears to be a better and safe alternative to CBA in treating patients with HD stenosis in terms of 6- and 12-month primary patency. However, a larger trial is warranted to establish these findings.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31445651</pmid><doi>10.1016/j.jvs.2019.01.082</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Angioplasty, Balloon - adverse effects Angioplasty, Balloon - instrumentation Arteriovenous Shunt, Surgical - adverse effects Cardiovascular Agents - administration & dosage Cardiovascular Agents - adverse effects Central venous stenosis Coated Materials, Biocompatible Conventional balloon angioplasty Dialysis access stenosis Drug-coated balloon Equipment Design Female Graft Occlusion, Vascular - etiology Graft Occlusion, Vascular - physiopathology Graft Occlusion, Vascular - therapy Humans Male Middle Aged Renal Dialysis Risk Factors Surgery Time Factors Treatment Outcome Vascular Access Devices Vascular Patency |
| title | A systematic review and meta-analysis of drug-coated balloon versus conventional balloon angioplasty for dialysis access stenosis |
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