BackgroundBoth drug‐coated balloon (DCB) angioplasty and conventional plain balloon angioplasty (PBA) can be implemented to treat hemodialysis dysfunction. The present study aims to compare the safety and efficacy of these 2 approaches by conducting a meta‐analysis of available randomized controlled trials.Methods and ResultsPubMed, Cochrane Library, and Embase databases were queried from establishment to January 2021. A total of 18 randomized controlled trials including 877 and 875 patients in the DCB and PBA groups, respectively, were included in the present meta‐analysis. Target lesion primary patency, circuit patency, target lesion revascularization, and mortality were pooled. Odds ratios (ORs) were reported with 95% CIs. Publication bias was analyzed with funnel plot and Egger test. Target lesion primary patency was higher among patients who underwent DCB (OR, 2.93 [95% CI, 2.13–4.03], P<0.001 at 6 months; OR, 2.47 [95% CI, 1.53–3.99], P<0.001 at 1 year). Also, the DCB group had a higher dialysis circuit patency at 6 months (OR, 2.42; 95% CI, 1.56–3.77 [P<0.001]) and 1 year (OR, 1.91; 95% CI, 1.22–3.00 [P=0.005]). Compared with the PBA group, the DCB group had lower odds of target lesion revascularization during follow‐up (OR, 0.43 [95% CI, 0.23–0.82], P=0.001 at 6 months; OR, 0.74 [95% CI, 0.32–1.73], P=0.490 at 1 year). The OR of mortality was comparable between 2 groups at 6 months (OR, 1.18; 95% CI, 0.42–3.33 [P=0.760]) and 1 year (OR, 0.93; 95% CI, 0.58–1.48 [P=0.750]).ConclusionsBased on evidence from 18 randomized controlled trials, DCB angioplasty is superior to PBA in maintaining target lesion primary patency and circuit patency among patients with dialysis circuit stenosis. DCB angioplasty also reduces target lesion revascularization with a similar risk of mortality compared with PBA.

中文翻译：

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药物涂层球囊与普通球囊血管成形术治疗血液透析功能障碍：随机对照试验的荟萃分析

背景药物涂层球囊 (DCB) 血管成形术和传统的普通球囊血管成形术 (PBA) 均可用于治疗血液透析功能障碍。本研究旨在通过对现有随机对照试验进行荟萃分析来比较这两种方法的安全性和有效性。方法和结果从建立到 2021 年 1 月查询了 PubMed、Cochrane 图书馆和 Embase 数据库。共有 18 个随机对照本荟萃分析包括分别包括 DCB 和 PBA 组的 877 名和 875 名患者的试验。汇总了靶病变初始通畅率、回路通畅率、靶病变血运重建和死亡率。报告的优势比 (OR) 为 95% CI。采用漏斗图和 Egger 检验分析发表偏倚。6 个月时P <0.001；或，2.47 [95% CI，1.53–3.99]， 1 年时P <0.001）。此外，DCB 组在 6 个月 (OR, 2.42; 95% CI, 1.56–3.77 [ P <0.001]) 和 1 年 (OR, 1.91; 95% CI, 1.22–3.00 [ P = 0.005]）。与 PBA 组相比，DCB 组在随访期间靶病变血运重建的几率更低（OR，0.43 [95% CI，0.23-0.82]， 6 个月时P = 0.001；OR，0.74 [95% CI，0.32 –1.73]，P = 0.490 在 1 年）。6 个月 (OR, 1.18; 95% CI, 0.42–3.33 [ P =0.760]) 和 1 年 (OR, 0.93; 95% CI, 0.58–1.48 [ P=0.750])。结论基于 18 项随机对照试验的证据，DCB 血管成形术在维持透析回路狭窄患者的目标病变初始通畅和回路通畅方面优于 PBA。与 PBA 相比，DCB 血管成形术还可以减少靶病变血运重建，死亡风险相似。