Paclitaxel Coated Balloon Angioplasty vs. Plain Balloon Angioplasty for Haemodialysis Arteriovenous Access Stenosis: A Systematic Review and a Time to Event Meta-Analysis of Randomised Controlled Trials

A systematic review and meta-analysis of randomised controlled trials (RCTs) was performed to determine the effectiveness safety drug coated balloon (DCB) angioplasty compared with uncoated plain (PB) in treating arteriovenous access stenosis. MEDLINE, Embase, Scopus, Cochrane Central Register Controlled Trials were searched for RCTs comparing paclitaxel DCB PB The last date literature search 31 December 2020. Risk bias retrieved studies assessed Collaboration tool assessing risk (RoB 2.0). random effects model used estimate loss target lesion patency (six 12 months) circuit months). Procedure related adverse events mortality rate also compared. Patency results pooled using time event meta-analytical method quality evidence according GRADE approach. Sixteen eligible trials, including 1 682 lesions, included quantitative analysis efficacy DCBs. DCBs associated a lower at six months (HR 0.53, 95% CI 0.42 – 0.66) 0.60, 0.47 0.76), improved month patency. Overall moderate low. Procedural complications rare, death up similar between two groups (OR 1.03, 0.68 1.56). Paclitaxel reduced stenosis PBs. Considering heterogeneity there is need investigate optimal treatment regimens regarding dose agent procedure.