Globally, more than 2.5 million people with kidney failure or end-stage renal disease (ESRD) regularly undergo hemodialysis (a procedure that filters waste and removes extra fluid from the blood when the kidneys fail).
To perform hemodialysis, a physician needs a way to repeatedly reach - or access - the bloodstream. This access is used to carry blood from the body to the dialysis machine where it is cleaned and returned to the body.
In some cases, the physician may create what is called an arteriovenous (AV) fistula (access site) in the arm to deliver hemodialysis to patients with kidney failure. In short, an AV fistula is like a lifeline for these patients.
“For some patients, over time, the AV fistula may become blocked, which reduces blood flow and limits the ability to use it effectively,” according to Shahriar Alizadegan MD, FACS, a vascular surgeon at Agnesian HealthCare, a member of SSM Health. “In order to restore function, patients often undergo one to three procedures per year to keep the AV fistula open.”
The need for frequent reinterventions can result in significant disruptions to critical hemodialysis care and more time away from home for patients who are already spending approximately three days per week at dialysis appointments. Drug-coated balloons have the potential to extend the time between reinterventions by keeping AV fistula patent and functioning, therefore maximizing a patient’s uninterrupted access to lifesaving dialysis care and time outside of the physician’s office.
Agnesian HealthCare is the first health care provider in the Midwest to offer the IN.PACT™ AV drug-coated balloon (DCB), a device that helps prevent vessel blockages by opening the AV fistula and depositing a drug that helps it stay in the patient longer, thereby minimizing the need for multiple reinterventions to keep the site working properly.
“While drug-coated balloons have been used for peripheral interventions,” says Dr. Alizadegan, “this technology was recently approved by FDA for use in AV fistulas. Use of this technology could potentially improve the patency of the fistulas and decrease the number of interventions required to perform to keep the fistula open and running.”
Dr. Alizadegan says Agnesian HealthCare and its vascular surgery team’s interest in using this technology was an important factor in its introduction in Fond du Lac.
“Some of these patients have to come back for fistulogram and intervention since there will be inevitable growth of abnormal inner layer of the vessels,” Dr. Alizadegan explains. “This process is called neointimal hyperplasia. Another reason for narrowing is repetitive puncture and access to the fistula. These balloons are covered with medications that slow down these processes.”
Individuals who are receiving hemodialysis and have had issues with their AV fistula staying open should talk with their physician to see if IN.PACT AV DCB is right for them. To learn more, call (920) 926-8540.