Long-term IN.PACT AV data show there is “definitely a place” for DCBs in dialysis access

Matteo Tozzi (Varese, Italy) and Kate Steiner (Stevenage, UK) sat down with Vascular News at this year’s Charing Cross (CX) International Symposium (23-25 April, London, UK) to provide their thoughts on the latest findings from the IN.PACT AV Access randomised controlled trial (RCT) evaluating the IN.PACT AV drug-coated balloon (DCB; Medtronic) in dialysis patients with dysfunctional arteriovenous fistulas (AVFs).
In light of five-year IN.PACT AV Access data-presented at CX 2024 by Andrew Holden (Auckland, New Zealand)-Tozzi points to the durability that these results demonstrate, as well as the positive cost effectiveness and reduced retreatment rate the IN.PACT AV DCB appears to enable compared to standard percutaneous transluminal angioplasty (PTA).
“In my clinical practice DCB is the first treatment for the stenosis in vascular access”, he comments, by noting that for patients on haemodialysis, “survival time is really linked to good functionality of the access circuit”, offering advice on optimal practices to his peers: “Please use DCB, […] because it’s the key point for maintaining the lives of these patients for the longest time possible.”
Steiner adds to these points, commenting that positive, long-term data from IN.PACT AV Access have now allayed any lingering mortality-related concerns regarding paclitaxel-“we can now use [DCBs] knowing that they are safe, in terms of mortality signals, in AV access”.
She goes on to note that, within the algorithm for treating patients with dysfunctional dialysis accesses, there is “definitely a place” for DCB use.
“If I wanted to persuade someone who was opposed to DCB use, I’d say, ‘come and talk to some of our patients’. […] We do have a few patients who are great advocates for the technology,” Steiner concludes.
This video is sponsored by Medtronic.